Systemic therapy targeting psoriatic inflammation associates with decreased incidence of dementia: An observational retrospective cohort study

Summary: Abstract Body: Psoriasis has been implicated in cognitive impairment and dementia. Recent findings indicate systemic inflammation may influence neuroinflammation and subsequent cytokine-driven neurodegeneration, though evidence remains inconclusive. We investigate the relationship between psoriasis and dementia and whether systemic treatments for psoriasis impact this association. Using TriNetX, we conducted a retrospective-cohort-study from 2004-2024. Individuals aged 65-95 without prior history of dementia were included. A control group of individuals without psoriasis [N=5337442] was compared to two experimental cohorts: 1) psoriasis patients receiving systemic therapies [N=14679] and 2) psoriasis patients managed without systemic therapies [N=39601] and matched 1:1 by demographics, BMI, and common risk factors for dementia. Odds Ratios (OR) with 95% confidence intervals were calculated to assess incidence of Alzheimer’s disease (AD), vascular, and nonvascular dementia, with sub-analyses based on systemic treatment. Outcomes were assessed over a period of up to 20-years. Psoriasis patients managed without systemic therapy were >49% more likely to develop AD (OR=1.56[1.39,1.75]), vascular (OR=1.56[1.35,1.81]), and nonvascular dementia (OR=1.49[1.39,1.60]) compared to controls. Conversely, psoriasis patients managed with systemic therapy were 31% less likely to develop AD (OR=0.69[0.54,0.86]) and 15% less likely to develop nonvascular dementia (OR=0.85[0.75,0.97]) compared to controls. Though fewer cases of vascular dementia existed amongst treated psoriasis patients compared to controls (105 vs 124), findings were not statistically significant (OR=0.85[0.65,1.10]). Untreated psoriasis is associated with a higher likelihood of dementia compared to non-psoriatic individuals. However, in the presence of systemic therapy, likelihood is markedly reduced. Results of this study warrant further research exploring the impact of systemic therapy on neurocognitive health of psoriasis patients. Madison P. Olexson¹, Ana J. Ormaza Vera¹, Chunghwan Ro¹, Clinton W. Enos¹ 1. Dermatology, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States. Clinical Research: Epidemiology and Observational Research