Neurology
Risk of Dementia in Patients with Adulthood Atopic dermatitis: A Systematic Review and Meta-analysis of Cohort Studies Parkin Paramiraksa* Parkin Paramiraksa Metavee Boonsiri Poramin Patthamalai Amarit Tansawet
Emerging yet contrasting evidence has reported the association between adulthood AD and the risk of developing dementia. We aim to determine the association between adulthood AD and the risk of incident dementia.
A systematic search of MEDLINE, Scopus, EMBASE, Cochrane Library, and medRxiv was performed through September 2023 to identify eligible cohort studies examining the risk of dementia among adults (age ≥18 years) with AD versus non-AD controls. Two reviewers independently extracted study characteristics and outcomes. Quality assessments were performed according to the Newcastle-Ottawa Scale (NOS). The PRISMA and Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed. The adjusted hazard ratio (aHR) were pooled using the random-effects meta-analysis. Subgroup analysis were conducted according to the types of dementia and severity of AD. Publication bias was evaluated by funnel plot.
Of 3,906 identified studies, 5 studies with 5 cohorts (n = 12,543,457 populations) were eligible for inclusion and were pooled in the meta-analysis. A significant association was found between AD and risk of incident all-cause dementia (pooled aHR, 1.13; 95% CI, 1.06-1.21; I2=81%). Subgroup analysis of dementia types illustrated a significantly increased risk of Alzheimer’s disease (pooled aHR, 1.13; 95% CI, 1.04-1.24; I2=80%) and vascular dementia (pooled aHR, 1.17; 95% CI, 1.11-1.24; I2 =11%). Interestingly, subgroup analysis of AD severity revealed that severe AD was associated with significantly increased risk for incident all-cause dementia (pooled aHR, 1.36; 95% CI, 1.21-1.54, I2=0%), but not in mild AD (pooled aHR, 1.52; 95% CI, 0.76-3.05, I2=85%). No evidence of publication bias was observed. Quality assessments of the included studies were high.
Patients with adulthood AD have a significantly increased risk of dementia. These findings may provide a reference for the clinical management of AD patients with baseline risk of dementia.