Association of atopic dermatitis severity with cognitive function in adults - 10/10/20
, 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 hAbstract |
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. |
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| Conflicts of interest: None disclosed. |
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| IRB approval status: The Northwestern University Institutional Review Boards approved the study. |
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| Reprints not available from the authors. |
Vol 83 - N° 5
P. 1349-1359 - novembre 2020 Retour au numéro
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