Department of Neurology, The First People's Hospital of Fuzhou, Fuzhou, Jiangxi, China.
Department of Neurology, Nanchang First Hospital, Nanchang, Jiangxi, China.
PLoS One. 2023 Oct 25;18(10):e0292987. doi: 10.1371/journal.pone.0292987. eCollection 2023.
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.
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).
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.
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.
PROSPERO, identifier (CRD42023411627).
特应性皮炎（AD）是一种常见的慢性炎症性皮肤病，影响着全世界的成年人。最近的证据表明，AD 可能与认知功能障碍有关，但个别研究的结果并不一致。本系统评价和荟萃分析旨在评估中年和老年人中 AD 与认知功能障碍之间的关系。
为了找到相关研究，我们全面检索了从开始到 2023 年 3 月的电子数据库。数据取自符合条件的研究，并进行荟萃分析以确定合并的危险比（HR）和 95%置信区间（CI）。
我们搜索了三个数据库，共纳入了 5 项队列研究中的 15 个研究臂，共纳入了超过 850 万名参与者。结果表明，AD 患者发生所有原因痴呆（合并 HR = 1.16；95%CI，1.10-1.23，P<0.001）和阿尔茨海默病型痴呆（合并 HR = 1.28；95%CI，1.01-1.63，P<0.001）的风险更高，但血管性痴呆（合并 HR = 1.42；95%CI，0.99-2.04，P<0.001）则不然。亚组分析表明，AD 与所有原因痴呆的相关性在欧洲显著（P = 0.004），而在亚洲则不显著（P = 0.173）；在前瞻性队列研究中显著（P<0.001），而非前瞻性队列研究中则不显著（P = 0.068）。敏感性分析和发表偏倚检测证实了总体结果的可靠性。
总之，本研究表明，AD 与中年和老年参与者认知功能障碍的风险增加有关，特别是阿尔茨海默病型痴呆和所有原因痴呆。需要进一步研究以了解这种关联的机制及其对临床实践的潜在影响。
PROSPERO，标识符（CRD42023411627）。
