Association of atopic dermatitis severity with cognitive function in adults

Jonathan I Silverberg, Donald Lei, Muhammad Yousaf, Sherief R Janmohamed, Paras P Vakharia, Rishi Chopra, Rajeev Chavda, Sylvie Gabriel, Kevin R Patel, Vivek Singam, Robert Kantor, Derek Y Hsu, David Cella

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


BACKGROUND: Atopic dermatitis (AD) is associated with itch, pain, and sleep disturbance, all of which may contribute toward cognitive dysfunction.

OBJECTIVE: To determine the relationship of AD severity and cognitive function in adults.

METHODS: We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n = 386). Cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form.

RESULTS: At baseline, 118 patients (58.1%) reported ≥1 symptoms of cognitive dysfunction in the past 4 weeks, with 29 (14.3%) having mild, 11 (5.4%) moderate, and 4 (2.0%) severe PROMIS Cognitive Function T-scores. In propensity score-weighted regression models, PROMIS Cognitive Function T-scores were inversely associated with patient-reported global AD severity, Patient Oriented Eczema Measure (POEM), Numeric Rating Scale worst itch and skin pain, SCORing Atopic Dermatitis (SCORAD)-sleep, POEM-sleep, Eczema Area and Severity Index, and SCORAD, with stepwise decreases of cognitive function with worsening AD severity. At all AD severity levels, cognitive dysfunction was associated with increased Dermatology Life Quality Index and ItchyQoL scores. Changes from baseline in PROMIS Cognitive Function T-scores were weakly to moderately inversely correlated with changes from baseline in multiple AD outcomes.

LIMITATIONS: Single-center study without non-AD controls.

CONCLUSION: Cognitive dysfunction is associated with AD severity. Cognitive function may be an important end point for monitoring treatment response in AD.

Original languageEnglish
Pages (from-to)1349-1359
Number of pages11
JournalJournal of the American Academy of Dermatology
Issue number5
Publication statusPublished - Nov 2020

Bibliographical note

Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.


  • atopic dermatitis
  • itch
  • pain
  • sleep disturbance


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