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Summary: Clinical question: Is psoriasis associated with dementia or cognitive impairment? Background: Psoriasis is a multisystemic inflammatory disorder that has an unclear association with cognitive dysfunction. Objectives: To conduct a Critically Appraised Topic that synthesizes the results from relevant observational studies. Methods: A systematic literature search of PubMed and Embase was conducted on 12 July 2019 to identify case–control, cross‐sectional or cohort studies that investigated the association between psoriasis and cognitive impairment or dementia. Risk of bias was assessed for each study, and the results presented in a narrative synthesis. Results: Eleven studies were included for critical appraisal. Of the 11 studies, 10 compared a total of 16 574 psoriasis cases with over 45 078 controls for risk of dementia or cognitive impairment. One of the 11 studies evaluated 7118 patients with dementia for odds of psoriasis compared with 21 354 controls. Six studies were assessed to have higher risk of bias. Nine of the 11 included studies found a significant positive association between the two diseases, one study a null association, and one study an inverse association. Discussion and recommendation: Most of the 11 included studies found a positive association between psoriasis and either mild cognitive impairment or dementia. Brief cognitive assessments have been suggested to screen older patients with psoriasis who present with subjective cognitive complaints. What is already known about this topic? Psoriasis and dementia are complex diseases with multifactorial pathogenesis, but share common inflammatory characteristics.There is evidence for a shared genetic and inflammatory pathogenesis between the two entities. What does this study add? Most observational studies found a significant positive association between psoriasis and cognitive impairment or dementia, and cognitive screening can be considered for patients with psoriasis who present with cognitive complaints.There is currently not enough evidence to suggest one specific systemic antipsoriatic treatment over another for patients with psoriasis showing mild cognitive impairment or dementia. Plain language summary available online [ABSTRACT FROM AUTHOR]

Linked Article: Yiu et al. Br J Dermatol 2020; 183:188–189. [ABSTRACT FROM AUTHOR]