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Association of atopic dermatitis severity with cognitive function in adults - 10/10/20

Doi : 10.1016/j.jaad.2020.05.041 
Jonathan I. Silverberg, MD, PhD, MPH a, b, , Donald Lei, MS b, Muhammad Yousaf, BS b, Sherief R. Janmohamed, MD, PhD b, Paras P. Vakharia, MD, PharmD c, Rishi Chopra, MD, MS d, Rajeev Chavda, MD e, Sylvie Gabriel, MD e, Kevin R. Patel, MD f, Vivek Singam, MD g, Robert Kantor, MD d, Derek Y. Hsu, MD b, David Cella, PhD h
a Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC 
b Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois 
c Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas 
d Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York 
e Galderma SA, Rx Strategy & Innovation Group, La Tour-de-Peliz, Switzerland 
f Department of Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts 
g Department of Internal Medicine, Weiss Memorial Hospital, Chicago, Illinois 
h Departments of Medical Social Sciences, Preventive Medicine, Neurology, and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 

Correspondence to: Jonathan I. Silverberg, MD, PhD, MPH, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Ste 2B-425, 2150 Pennsylvania Ave, Washington, DC 20037.Department of DermatologyThe George Washington University School of Medicine and Health SciencesSte 2B-4252150 Pennsylvania AveWashingtonDC20037

Abstract

Background

Atopic dermatitis (AD) is associated with itch, pain, and sleep disturbance, all of which may contribute toward cognitive dysfunction.

Objective

To determine the relationship of AD severity and cognitive function in adults.

Methods

We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n = 386). Cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form.

Results

At baseline, 118 patients (58.1%) reported ≥1 symptoms of cognitive dysfunction in the past 4 weeks, with 29 (14.3%) having mild, 11 (5.4%) moderate, and 4 (2.0%) severe PROMIS Cognitive Function T-scores. In propensity score-weighted regression models, PROMIS Cognitive Function T-scores were inversely associated with patient-reported global AD severity, Patient Oriented Eczema Measure (POEM), Numeric Rating Scale worst itch and skin pain, SCORing Atopic Dermatitis (SCORAD)-sleep, POEM-sleep, Eczema Area and Severity Index, and SCORAD, with stepwise decreases of cognitive function with worsening AD severity. At all AD severity levels, cognitive dysfunction was associated with increased Dermatology Life Quality Index and ItchyQoL scores. Changes from baseline in PROMIS Cognitive Function T-scores were weakly to moderately inversely correlated with changes from baseline in multiple AD outcomes.

Limitations

Single-center study without non-AD controls.

Conclusion

Cognitive dysfunction is associated with AD severity. Cognitive function may be an important end point for monitoring treatment response in AD.

Le texte complet de cet article est disponible en PDF.

Key words : atopic dermatitis, burden, cognition, concentration, eczema, executive function, itch, memory, patient-reported outcomes, pruritus, quality of life, severity

Abbreviations used : AD, DLQI, EASI, HRQOL, NRS, POEM, PROMIS, SCORAD, SF


Plan


 Funding sources: This publication was made possible with support from the Agency for Healthcare Research and Quality (AHRQ), grant number K12-HS023011, the Dermatology Foundation, and an unrestricted research grant from Galderma, LLC.
 Conflicts of interest: None disclosed.
 IRB approval status: The Northwestern University Institutional Review Boards approved the study.
 Reprints not available from the authors.


© 2020  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 83 - N° 5

P. 1349-1359 - novembre 2020 Retour au numéro
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