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.

中文翻译：

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银屑病与认知、脑成像标志物和痴呆风险无关：鹿特丹研究

背景

基于增加的心脏代谢合并症、炎症以及与阿尔茨海默病的遗传重叠，银屑病患者可能面临认知功能障碍和痴呆的风险。

客观的

在基于人群的鹿特丹研究中比较银屑病和非银屑病参与者的认知、磁共振成像 (MRI) 标志物和痴呆风险。

方法

我们确定了 318 名银屑病患者和 9678 名非银屑病患者（平均年龄 66.1 岁，58% 为女性）。通过线性和逻辑回归检查银屑病与认知功能、轻度认知障碍和脑损伤 MRI 标志物的关联。使用 Cox 回归计算痴呆风险。模型针对年龄、性别、教育和心血管危险因素进行了调整。

结果

银屑病（28% 全身和紫外线治疗）和非银屑病参与者的认知测试分数和脑 MRI 的体积、显微结构、局灶测量没有差异，银屑病与轻度认知障碍无关（调整比值比 0.87，95% 置信区间 0.53 -1.43)。在 115,000 人年的随访中，发生了 810 例痴呆病例（15 例在牛皮癣患者中）。在调整混杂因素后，银屑病与患痴呆症的风险较低相关（调整后的风险比为 0.50，95% 置信区间为 0.28-0.91）。

限制

银屑病患者中的痴呆病例有限。

结论

在这项基于人群的研究中，银屑病与临床前标志物或更高的痴呆风险无关。