Patients with vitiligo may be more likely to develop dementia than patients without vitiligo, according to findings from a retrospective cohort study published in the Journal of Dermatology. Vitiligo and dementia may be linked as they both involve autoimmune-related inflammation, it was posited.
Investigators analyzed data from Taiwanese adults aged 45 years or older with and without the diagnosis of vitiligo from January 1, 1998 to December 31, 2011. All enrolled participants were followed up until dementia diagnosis, death, or December 31, 2013, whichever occurred first.
The primary study outcome was the occurrence of dementia as ascertained by a board-certified psychiatrist or neurologist at least twice in the follow-up period. Investigators also analyzed the association between vitiligo and the risk for developing Alzheimer dementia (AD) and vascular dementia (VD), and the influence of phototherapy, sex, middle-age, and old age on study outcomes.
Results showed a 5-fold increased risk for dementia in adult patients with vitiligo. A total of 1320 patients with vitiligo and 5280 control patients were included, and the median follow-up duration was 5 to 6 years for both cohorts (P =0.387). The crude incidence rate per 100,000 person-years in the follow-up period for dementia was 502.8 for patients with vitiligo and 101.9 for control patients. The adjusted hazard ratio (aHR) was 5.30 for patients with vitiligo (95% CI, 3.30-8.51) compared with control patients.
Patients with vitiligo had an increased risk for developing AD (aHR, 12.22; 95% CI, 3.71-40.28) and VD (aHR, 3.99; 95% CI, 1.31-12.15) compared with control patients. There was a significantly increased risk for developing dementia in both women (aHR, 4.35; 95% CI, 2.21-8.57) and men (aHR, 7.13; 95% CI, 3.66-13.88) and in middle-aged (aHR 15.24; 95% CI, 3.02-76.84) and older age (aHR, 4.85; 95% CI, 2.93-8.04) groups. Patients with vitiligo had an increased risk for developing dementia whether or not they underwent phototherapy.
Study limitations included the potential for underestimating dementia incidence, possible misclassification bias for dementia, and lack of information on important confounding factors such as smoking, alcohol consumption, body mass index, lifestyle, and family history.
“This novel finding reminds physicians to be more careful about signs of dementia when managing patients with vitiligo and provides a basis for further investigations that clarify the underlying mechanisms,” the study authors wrote.
Chang TH, Tai YH, Dai YX, Chang YT, Chen TJ, Chen MH. Association between vitiligo and subsequent risk of dementia: a population-based cohort study. J Dermatol. 2021;48(1):28-33. doi:10.1111/1346-8138.15582