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Meta-Analysis
. 2023 Oct 25;18(10):e0292987.
doi: 10.1371/journal.pone.0292987. eCollection 2023.

Atopic dermatitis and cognitive dysfunction in middle-aged and older adults: A systematic review and meta-analysis

Qi Zhou  1 , Dejiang Yang  2 , Chongyu Xiong  1 , Xinming Li  2
Affiliations
Meta-Analysis

Atopic dermatitis and cognitive dysfunction in middle-aged and older adults: A systematic review and meta-analysis

Qi Zhou et al. PLoS One. .

Abstract

Background: Atopic dermatitis (AD) is a common chronic inflammatory skin disease that affects adults worldwide. Recent evidence suggests that AD may be associated with cognitive dysfunction, but the results of individual studies have been inconsistent. This systematic review and meta-analysis aimed to evaluate the association between AD and cognitive dysfunction in middle-aged and older adults.

Methods: To find relevant research, a comprehensive search of electronic databases from the beginning to March 2023 was carried out. Data were taken from studies that were eligible, and a meta-analysis was done to determine the pooled hazard ratio (HR) and 95% confidence interval (CI).

Results: We searched three databases and found a total of 15 studied arms included in 5 cohort studies with over 8.5 million participants were included in the analysis. The results showed that individuals with AD had a higher risk of developing dementia of all-cause dementia (pooled hazard ratio (HR) = 1.16; 95% CI, 1.10-1.23,P<0.001) and the Alzheimer type (pooled HR = 1.28; 95% CI, 1.01-1.63,P<0.001) but not vascular dementia (pooled HR = 1.42; 95% CI, 0.99-2.04,P<0.001). Subgroup analyses showed that the association between atopic dermatitis and all-cause dementia was significant in Europe (P = 0.004) but not in Asia (P = 0.173) and was significant in prospective cohort studies (P<0.001) but not in non-prospective cohort studies (P = 0.068). Sensitivity analysis and publication bias detection confirmed the reliability of the overall findings.

Conclusions: In conclusion, this study demonstrated that AD was associated with increased risk of cognitive dysfunction, particularly dementia of the Alzheimer type and all-cause dementia, in middle-aged and older participants. Further research is needed to understand the mechanisms behind this association and its potential implications for clinical practice.

Systematic review registration: PROSPERO, identifier (CRD42023411627).

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart displaying the choice of study.
Fig 2
Fig 2. The forest plot shows the pooled HR for all-cause dementia, Alzheimer’s disease dementia and vascular dementia in atopic dermatitis vs non-atopic dermatitis.
Fig 3
Fig 3. The sensitivity analyses performed to validate the stability of pooled HRs of cohort literature by removing Joh et al. study for (A) all-cause dementia, (B) Alzheimer’s disease dementia and (C) vascular dementia.
See this image and copyright information in PMC

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