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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1349-1359 |
| Number of pages | 11 |
| Journal | Journal of the American Academy of Dermatology |
| Volume | 83 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 2020 |
Funding
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.The Northwestern Medicine Enterprise Data Warehouse was partly supported by the Northwestern University Clinical and Translational Science Institute, funded, in part, by Grant Number UL1-TR-000150 from the National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Clinical and Translational Science Award (CTSA) is a registered trademark of United States Department of Health and Human Services. 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 . The Northwestern Medicine Enterprise Data Warehouse was partly supported by the Northwestern University Clinical and Translational Science Institute , funded, in part, by Grant Number UL1-TR-000150 from the National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Clinical and Translational Science Award (CTSA) is a registered trademark of United States Department of Health and Human Services.
Keywords
- atopic dermatitis
- burden
- cognition
- concentration
- eczema
- executive function
- itch
- memory
- patient-reported outcomes
- pruritus
- quality of life
- severity
ASJC Scopus subject areas
- Dermatology