Modifiable Risk Factors and Cognitive Impairment in Patients With Psoriasis

Fixed and potentially modifiable risk factors for cognitive impairment (CI) in patients with psoriasis include older age, female sex, comorbidities, fewer years of education, and rural residence, according to study findings published in Journal of the European Academy of Dermatology and Venereology.

The study included 306 patients (median age, 42 years) with psoriasis, including 91 patients with psoriatic arthritis, who were prospectively enrolled from January to September 2019. The investigators defined mild CI (MCI) and dementia with a Montreal Cognitive Assessment score of 18 to 25 and less than 18, respectively. There were 118 patients with CI and 188 patients without CI.

The overall incidence of CI, which included both dementia and MCI, was 38.56%. The incidence of dementia was 1.63%, and the incidence of MCI was 36.93%. In contrast, it was noted that the corresponding overall incidence of CI in a healthy control group was 6.04% (0.34% for dementia and 5.70% for MCI).

According to the researchers, the incidence of both dementia and MCI in those between ages of 60 and 69 years was higher than reported in healthy control participants and the reported literature. Variables associated with increased odds of CI in patients with psoriasis in the multivariate logistic regression analysis included older age, female sex, fewer years of education, and rural residence. Other risk factors included comorbidities such as hyperglycemia and hyperlipidemia.

The researchers explained that the high rate of CI in this study may be due to the study’s cohort comprising newly diagnosed patients who had not received systemic therapy. As such, these patients may not have received much-needed therapy that could “reverse the inflammatory process that could be related to CI in patients with psoriasis.”

In addition, the investigators noted that the patients in the study may have been sicker than patients from previous studies, as the former group of patients were enrolled form a tertiary-care hospital specialized in psoriasis management. Likewise, the investigators suggest these “sicker patients with more severe inflammation may have more cognitive issues.”

The researchers concluded that improved understanding of “the presence and extent of CI, and to assess the risk factors, should be helpful to diagnose CI early and to devise strategies to prevent progression to CI in patients with psoriasis.”

Reference

Kuang Y, Luo Y, Yi X, et al. Prevalence and risk factors for cognitive impairment in patients with psoriasis. J Eur Acad Dermatol Venereol. Published online September 28, 2021. doi:10.1111/jdv.17707