Graduate Institute of Biomedical Informatics, College of Medicine Science and Technology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan.
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Am J Clin Dermatol. 2019 Jun;20(3):457-463. doi: 10.1007/s40257-018-00420-8.
Dementia is a syndrome that involves the deterioration of several higher mental functions in advanced age, and psoriasis is an autoimmune disease characterized by skin plaque. Epidemiological studies have indicated an association between dementia and psoriasis; however, to date, no studies in Asia have reported this association.
This study used a population-based medical dataset to explore the association between previously diagnosed psoriasis and dementia in Taiwan.
Using the Taiwan Longitudinal Health Insurance Database 2000, we identified 7118 individuals with a diagnosis of dementia; a further 21,354 sex- and aged-matched individuals were randomly extracted as controls. Patients with bullous pemphigoid, which is characterized by inflammatory phenomena similar to that evident in psoriasis, were chosen as a control group. Conditional logistic regression was performed to evaluate the association between dementia and prior psoriasis or bullous pemphigoid among the sampled patients.
Of the 28,472 individuals, 2.2, 3.0, and 1.5% of the total, case, and control groups, respectively, had been diagnosed with psoriasis. After adjustments were made for patients' monthly income, region, urbanization level, diabetes, hyperlipidemia, hypertension, and coronary heart disease, the odds ratio (OR) of diagnosed psoriasis for the case group was 1.46 (95% confidence interval [CI] 1.23-1.73; p < 0.001) compared with the control group. The ORs of a previous psoriasis diagnosis with arthritis and without arthritis in the case group were, respectively, 1.95 and 1.44 times (95% CI 1.03-3.89 and 1.21-1.72, respectively) those of the control group after adjustments for socioeconomic variables, diabetes, hyperlipidemia, hypertension, and coronary heart disease. However, no significant differences in prior bullous pemphigoid were observed between the dementia and control groups (0.5% and 0.4%, respectively).
More patients with dementia had prior psoriasis than did patients in the control group. Additional research is required to confirm our results and clarify the relationship.
痴呆是一种综合征，涉及高龄时多种高级精神功能的恶化，而银屑病是一种以皮肤斑块为特征的自身免疫性疾病。流行病学研究表明痴呆与银屑病之间存在关联；然而，迄今为止，亚洲尚无研究报告这种关联。
本研究使用基于人群的医疗数据集探讨台湾地区先前诊断的银屑病与痴呆之间的关系。
使用台湾纵向健康保险数据库 2000 年的数据，我们确定了 7118 名痴呆症患者；进一步随机抽取 21354 名性别和年龄匹配的个体作为对照组。选择大疱性类天疱疮患者作为对照组，因为他们的炎症现象与银屑病相似。对抽样患者进行条件逻辑回归分析，以评估痴呆与先前银屑病或大疱性类天疱疮之间的关系。
在 28472 名个体中，总病例组、病例组和对照组中分别有 2.2%、3.0%和 1.5%被诊断为银屑病。在调整了患者的月收入、地区、城市化水平、糖尿病、高血脂、高血压和冠心病后，病例组诊断为银屑病的优势比（OR）为 1.46（95%置信区间 [CI] 1.23-1.73；p<0.001）与对照组相比。在病例组中，有和没有关节炎的先前银屑病诊断的 OR 分别为对照组的 1.95 倍和 1.44 倍（95%CI 1.03-3.89 和 1.21-1.72），这些 OR 在调整了社会经济变量、糖尿病、高血脂、高血压和冠心病后得到了进一步确认。然而，痴呆症组与对照组之间先前大疱性类天疱疮的差异无统计学意义（分别为 0.5%和 0.4%）。
痴呆症患者中先前有银屑病的患者比对照组多。需要进一步的研究来证实我们的结果并阐明这种关系。
