Abstract
Introduction
Sjögren's syndrome (SS) is an autoimmune disorder involving the exocrine glands, which
affects 1.9–3.0% of the elderly population. Approximately 20% of all patients with
SS have CNS involvement, including dementia, as a result of angiitis.
Aims
The aim of the study was to clarify the prevalence and impact of SS among patients
in a memory clinic.
Methods
This study prospectively recruited patients with cognitive dysfunction in a memory
clinic from 2007 to 2010. In addition to the examinations for dementia, the patients'
levels of anti-SSA and SSB antibodies were measured. Schirmer's test and/or a lip
biopsy were added if required. SS was diagnosed based on the American European consensus
criteria.
Results
Out of 276 cases who completed the examinations, 265 (97/168 males/females, mean age:
77.9, median MMSE score: 23) did not demonstrated cognitive decline. Sixteen (6.3%)
and seven (2.7%) patients were positive for anti-SS-A and SS-B antibodies, respectively.
Twenty patients (7.5%) were diagnosed with primary SS (mean age: 77.2 years old, median MMSE: 21). Seven of these patients had previously been diagnosed
with MCI (VCIND: 5, aMCI: 2), and 13 had been diagnosed with dementia. All had asymmetrical
focal hypoperfusion on SPECT, and eighteen had subcortical lesions on MRI. Twelve
were treated for dementia (median time: 2.1 years), and their MMSE significantly improved (median MMSE: 26, p=0.0019), while the non-SS subjects' MMSE declined (n=126, median: 22).
Conclusion
The patients with SS accounted for 7.5% of those with a cognitive decline as determined
at a memory clinic, and are characterized by subcortical white matter lesions and
asymmetric hypoperfusion.
Keywords
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Article info
Publication history
Published online: August 20, 2012
Accepted:
July 26,
2012
Received in revised form:
July 25,
2012
Received:
January 28,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
