Dermatology Hospital, Southern Medical University, Guangdong, China.
Dermatology Service, Veterans Affairs Medical Center San Francisco, San Francisco, California, USA.
J Eur Acad Dermatol Venereol. 2022 Oct;36(10):1705-1712. doi: 10.1111/jdv.18360. Epub 2022 Jul 2.
Cognitive impairment is a symptom of neurological disorders, including dementia and Alzheimer's disease; and mild cognitive impairment can be a precursor of both disorders. Aged humans and animal models with other systemic disorders, such as cardiovascular diseases and diabetes, display a higher incidence of cognitive decline. Epidemiological studies have shown that the incidence of cognitive impairment also is higher in subjects with certain inflammatory skin disorders, including psoriasis and chronic eczematous dermatitis. Chronologically aged individuals exhibit increased cutaneous inflammation and elevated circulating cytokine levels, linked to alterations in epidermal function, which itself can induce cutaneous inflammation. Conversely, strategies that improve epidermal function can lower cytokine levels in both the skin and circulation. Thus, it seems likely that epidermal dysfunction could contribute, at least in part, to the development of chronic low-grade inflammation, also termed 'inflammaging', in the elderly. The evidence of cognitive impairment in patients with inflammatory dermatoses suggests a link between cutaneous inflammation and cognitive impairment. Because of the pathogenic role of epidermal dysfunction in ageing-associated cutaneous inflammation, improvements in epidermal function could be an alternative approach for mitigation of the ageing-associated decline in cognitive function.
认知障碍是神经紊乱的一种症状,包括痴呆和阿尔茨海默病;轻度认知障碍可能是这两种疾病的前兆。患有其他系统性疾病的老年患者和动物模型,如心血管疾病和糖尿病,认知能力下降的发生率更高。流行病学研究表明,某些炎症性皮肤疾病(包括银屑病和慢性湿疹性皮炎)患者的认知障碍发生率也更高。随着年龄的增长,皮肤炎症增加,循环细胞因子水平升高,这与表皮功能的改变有关,而表皮功能的改变本身就可以引发皮肤炎症。相反,改善表皮功能的策略可以降低皮肤和循环中的细胞因子水平。因此,表皮功能障碍至少在一定程度上可能导致老年人慢性低度炎症的发展,这种炎症也被称为“炎症衰老”。炎症性皮肤病患者认知障碍的证据表明皮肤炎症与认知障碍之间存在关联。由于表皮功能障碍在与年龄相关的皮肤炎症中的致病作用,改善表皮功能可能是减轻与年龄相关的认知功能下降的另一种方法。