Psoriasis is not associated with cognition, brain imaging markers, and risk for dementia: The Rotterdam Study - 11/02/21

Doi : 10.1016/j.jaad.2018.07.046

Elena Pezzolo, MD ^a,^b, Unal Mutlu, MD, MSc ^c,^d, Meike W. Vernooij, MD, PhD ^c,^e, Emmilia A. Dowlatshahi, MD, PhD ^a, Paolo Gisondi, MD ^b, Giampiero Girolomoni, MD ^b, Tamar Nijsten, MD, PhD ^a, M. Arfan Ikram, MD, PhD ^c, Marlies Wakkee, MD, PhD ^a,^⁎
^a Department of Dermatology, Erasmus Medical Center University Medical Center, Rotterdam, the Netherlands
^b Department of Medicine, Section of Dermatology and Venerology, University of Verona, Verona, Italy
^c Department of Epidemiology, Erasmus Medical Center University Medical Center, Rotterdam, the Netherlands
^d Department of Ophthalmology, Erasmus Medical Center University Medical Center, Rotterdam, the Netherlands
^e Department of Radiology and Nuclear Medicine, Erasmus Medical Center University Medical Center, Rotterdam, the Netherlands

^∗Correspondence to: Marlies Wakkee, MD, PhD, Department of Dermatology, Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.Department of DermatologyMolewaterplein 40Rotterdam3015 GDthe Netherlands

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Abstract

Background

Based on increased cardiometabolic comorbidities, inflammation, and an overlap in genetics with Alzheimer disease, psoriasis patients might be at risk for cognitive dysfunction and dementia.

Objective

To compare cognition, magnetic resonance imaging (MRI)–markers, and dementia risk in psoriasis and nonpsoriasis participants in the population-based Rotterdam Study.

Methods

We identified 318 psoriasis and 9678 nonpsoriasis participants (mean age 66.1 years, 58% women). The association of psoriasis with cognitive function, mild cognitive impairment, and MRI-markers of brain damage was examined by linear and logistic regression. Dementia risk was calculated using Cox regression. Models were adjusted for age, sex, education, and cardiovascular risk factors.

Results

Cognitive test scores and volumetric, microstructural, focal measures on brain MRI did not differ between psoriasis (28% systemic and ultraviolet treatment) and nonpsoriasis participants, and psoriasis was not associated with mild cognitive impairment (adjusted odd ratio 0.87, 95% confidence interval 0.53-1.43). During 115.000 person-years of follow-up, 810 incident dementia cases (15 among psoriasis patients) occurred. After adjusting for confounders, psoriasis was associated with a lower risk of developing dementia (adjusted hazard ratio 0.50, 95% confidence interval 0.28-0.91).

Limitations

Limited dementia cases among psoriasis patients.

Conclusion

In this population-based study, psoriasis was not associated with preclinical markers or higher dementia risk.

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Key words : brain MRI-correlates, dementia, global cognition factor, neuropsychological tests, psoriasis

Abbreviations used : AD, CI, HR, LDST, MCI, MRI, MMSE, WML

Plan

Methods

Study design

Study population

Assessment of psoriasis

Reference population

Assessment of cognitive function and mild cognitive impairment

Magnetic resonance imaging markers

Cognitive function and mild cognitive impairment

	Funding sources: Supported by the Erasmus University Medical Center and Erasmus University, Rotterdam; the Netherlands Organisation for Scientific Research; the Netherlands Organization for Health Research and Development; Research Institute for Diseases in the Elderly; Ministry of Education, Culture, and Science; Ministry of Health, Welfare, and Sports; European Commission (DGXII); and Municipality of Rotterdam.
	Conflicts of interest: None disclosed.
	Reprints not available from the authors.