Psoriasis is not associated with cognition, brain imaging markers, and risk for dementia: The Rotterdam Study

Elena Pezzolo, Unal Mutlu, Meike W. Vernooij, Emmilia A. Dowlatshahi, Paolo Gisondi, Giampiero Girolomoni, Tamar Nijsten, M. Arfan Ikram, Marlies Wakkee*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Scopus)


Background: Based on increased cardiometabolic comorbidities, inflammation, and an overlap in genetics with Alzheimer disease, psoriasis patients might be at risk for cognitive dysfunction and dementia. Objective: To compare cognition, magnetic resonance imaging (MRI)–markers, and dementia risk in psoriasis and nonpsoriasis participants in the population-based Rotterdam Study. Methods: We identified 318 psoriasis and 9678 nonpsoriasis participants (mean age 66.1 years, 58% women). The association of psoriasis with cognitive function, mild cognitive impairment, and MRI-markers of brain damage was examined by linear and logistic regression. Dementia risk was calculated using Cox regression. Models were adjusted for age, sex, education, and cardiovascular risk factors. Results: Cognitive test scores and volumetric, microstructural, focal measures on brain MRI did not differ between psoriasis (28% systemic and ultraviolet treatment) and nonpsoriasis participants, and psoriasis was not associated with mild cognitive impairment (adjusted odd ratio 0.87, 95% confidence interval 0.53-1.43). During 115.000 person-years of follow-up, 810 incident dementia cases (15 among psoriasis patients) occurred. After adjusting for confounders, psoriasis was associated with a lower risk of developing dementia (adjusted hazard ratio 0.50, 95% confidence interval 0.28-0.91). Limitations: Limited dementia cases among psoriasis patients. Conclusion: In this population-based study, psoriasis was not associated with preclinical markers or higher dementia risk.

Original languageEnglish
Pages (from-to)671-680
Number of pages10
JournalJournal of the American Academy of Dermatology
Issue number3
Publication statusPublished - 1 Sept 2021

Bibliographical note

Funding Information:
Funding sources: Supported by the Erasmus University Medical Center and Erasmus University , Rotterdam; the Netherlands Organisation for Scientific Research ; the Netherlands Organization for Health Research and Development; Research Institute for Diseases in the Elderly; Ministry of Education, Culture, and Science ; Ministry of Health, Welfare, and Sports ; European Commission (DGXII); and Municipality of Rotterdam .

Publisher Copyright:
© 2018 American Academy of Dermatology, Inc.


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