Patient-reported neurocognitive symptoms influence instrumental activities of daily living in sickle cell disease.
Journal
American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
revised:
29
07
2021
received:
23
04
2021
accepted:
02
08
2021
pubmed:
6
8
2021
medline:
16
11
2021
entrez:
5
8
2021
Statut:
ppublish
Résumé
Individuals with sickle cell disease (SCD) experience neurocognitive decline, low medication adherence, increased unemployment, and difficulty with instrumental activities of daily living (IADL). The relationship between self-perceived cognitive difficulties and IADLs, including employment, school enrollment, independence, engagement in leisure activities, and medication adherence is unknown. We hypothesized that self-reported difficulties across neurocognitive areas would predict lower IADL skills. Adolescent and adult participants of the multi-site Sickle Cell Disease Implementation Consortium (SCDIC) (n = 2436) completed patient-reported outcome (PRO) measures of attention, executive functioning, processing speed, learning, and comprehension. Cognitive symptoms were analyzed as predictors in multivariable modeling. Outcome variables included 1) an IADL composite that consisted of employment, participation in school, reliance on others, and leisure pursuits, and 2) hydroxyurea adherence. Participants reported cognitive difficulty across areas of attention (55%), executive functioning (51%), processing speed (57%), and reading comprehension (65%). Executive dysfunction (p < 0.001) and sometimes or often experiencing learning difficulties (p < 0.001 and p = 0.04) and poor comprehension (p = 0.000 and p = 0.001), controlled for age (p < 0.001), pain (p < 0.001), and hydroxyurea use (p = 0.001), were associated with poor IADL skills. Executive functioning difficulties (p = 0.021), controlled for age (p = 0.013 for ages 25-34), genotype (p = 0.001), and hemoglobin (p = 0.004), predicted hydroxyurea non-adherence. Analysis of PRO measures indicated that cognitive dysfunction is prevalent in adolescents and adults with SCD. Cognitive dysfunction translated into clinically meaningful outcomes. PRO of cognitive symptoms can be used as an important adjunct clinical tool to monitor symptoms that impact functional skills, including engagement in societal activities and medication adherence.
Identifiants
pubmed: 34350622
doi: 10.1002/ajh.26315
pmc: PMC8855994
mid: NIHMS1772800
doi:
Substances chimiques
Antisickling Agents
0
Hydroxyurea
X6Q56QN5QC
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1396-1406Subventions
Organisme : US Federal Government Cooperative Agreements
ID : U01HL133994
Organisme : NHLBI NIH HHS
ID : U24 HL133948
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL134042
Pays : United States
Organisme : US Federal Government Cooperative Agreements
ID : U01HL133964
Organisme : NHLBI NIH HHS
ID : U01 HL133994
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL133964
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL134007
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL133997
Pays : United States
Organisme : US Federal Government Cooperative Agreements
ID : U01HL134042
Organisme : US Federal Government Cooperative Agreements
ID : U01HL133996
Organisme : NHLBI NIH HHS
ID : U01 HL134004
Pays : United States
Organisme : US Federal Government Cooperative Agreements
ID : U01HL134004
Organisme : US Federal Government Cooperative Agreements
ID : U24HL133948
Organisme : US Federal Government Cooperative Agreements
ID : U01HL134007
Organisme : NHLBI NIH HHS
ID : U01 HL133990
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL133996
Pays : United States
Organisme : US Federal Government Cooperative Agreements
ID : U01HL133997
Organisme : US Federal Government Cooperative Agreements
ID : U01HL133990
Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
J Clin Exp Neuropsychol. 2016 Aug;38(6):661-71
pubmed: 27167865
BMJ. 2003 Nov 15;327(7424):1151-5
pubmed: 14615343
JAMA. 2010 May 12;303(18):1823-31
pubmed: 20460621
Health Psychol Open. 2020 Apr 28;7(1):2055102920917250
pubmed: 32426150
Am J Occup Ther. 2015 Mar-Apr;69(2):6902350030p1-5
pubmed: 26122692
J Neurosci. 2001 Nov 15;21(22):8819-29
pubmed: 11698594
Health Aff (Millwood). 2016 Apr;35(4):575-82
pubmed: 27044954
J Pediatr Psychol. 2019 Sep 1;44(8):948-958
pubmed: 31050352
JMIR Res Protoc. 2020 Jul 14;9(7):e16319
pubmed: 32442144
JAMA. 2014 Sep 10;312(10):1033-48
pubmed: 25203083
Blood Adv. 2020 Sep 22;4(18):4463-4473
pubmed: 32941646
Arch Clin Neuropsychol. 2016 Sep;31(6):506-16
pubmed: 27475282
J Natl Med Assoc. 2010 Nov;102(11):993-9
pubmed: 21141286
Alzheimers Res Ther. 2015 Mar 18;7(1):17
pubmed: 25815063
Gerontologist. 1969 Autumn;9(3):179-86
pubmed: 5349366
Pediatr Blood Cancer. 2011 Apr;56(4):620-4
pubmed: 21298749
Am J Hematol. 2020 Sep;95(9):1066-1074
pubmed: 32449965
Clin Neuropsychol. 2000 May;14(2):187-95
pubmed: 10916193
Orphanet J Rare Dis. 2020 Jul 7;15(1):178
pubmed: 32635939
Am J Hematol. 2011 Mar;86(3):273-7
pubmed: 21328441
JMIR Mhealth Uhealth. 2020 May 8;8(5):e14884
pubmed: 32383683
AJNR Am J Neuroradiol. 2003 Mar;24(3):382-9
pubmed: 12637286
J Health Care Poor Underserved. 2010 Nov;21(4):1124-37
pubmed: 21099066
Transl Behav Med. 2015 Dec;5(4):470-82
pubmed: 26622919
Expert Rev Hematol. 2020 Nov;13(11):1165-1173
pubmed: 33034214
N Engl J Med. 2005 Aug 4;353(5):487-97
pubmed: 16079372
Am J Hematol. 2021 Apr 1;96(4):404-417
pubmed: 33264445