235 Phenotypes of cognitive dysfunction in adults with atopic dermatitis

Abstract

Importance: Atopic Dermatitis (AD) was recently shown to be associated with cognitive dysfunction in adults. Yet, little is known about the patterns of cognitive deficits experienced by patients suffering from AD. Objective: To investigate the phenotypes of cognitive deficits and their predictors in adults with AD. Methods: A prospective dermatology practice-based study was performed using questionnaires and evaluation by a dermatologist (n=195). Cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form. Results: Latent class analyses identified 4 major cognitive subtypes in adults with AD: normal cognition (71.88%), concentration deficit (14.64%), moderate cognitive impairment (CI; 7.71%), and severe CI (5.77%). Patients with severe CI at baseline were more likely to have persistent CI over time (60.06%) than those with moderate CI (25.39%) or concentration deficit (0.00%). Patients with a concentration deficit, moderate, and severe CI were more likely to have moderate-severe SCORing AD (SCORAD; 77.78%, 90.48% and 75.00% vs 59.05%; p=0.03), moderate depression (Patient Health Questionnaire [PHQ]-9; 35.71%, 50.00% and 83.33% vs 8.57% PHQ9; p<0.0001), and severely impacted quality of life (Dermatology Life Quality Index [DLQI]; 57.14%, 57.14% and 66.67% vs 27.86%; p= 0.008) compared to those with normal cognitive function. Patients with moderate and severe CI additionally reported more severe skin pain (38.10% and 83.33% vs 19.39%; p<0.0001). Conclusions: Three distinct phenotypes of cognitive dysfunction were identified in adults with AD. The occurrence of depression, a severely impacted quality of life and skin pain increased with increasing levels of cognitive dysfunction.