Skip to main content
Log in

Association Between Psoriasis and Dementia: A Population-Based Case–Control Study

  • Original Research Article
  • Published:
American Journal of Clinical Dermatology Aims and scope Submit manuscript



Dementia is a syndrome that involves the deterioration of several higher mental functions in advanced age, and psoriasis is an autoimmune disease characterized by skin plaque. Epidemiological studies have indicated an association between dementia and psoriasis; however, to date, no studies in Asia have reported this association.


This study used a population-based medical dataset to explore the association between previously diagnosed psoriasis and dementia in Taiwan.


Using the Taiwan Longitudinal Health Insurance Database 2000, we identified 7118 individuals with a diagnosis of dementia; a further 21,354 sex- and aged-matched individuals were randomly extracted as controls. Patients with bullous pemphigoid, which is characterized by inflammatory phenomena similar to that evident in psoriasis, were chosen as a control group. Conditional logistic regression was performed to evaluate the association between dementia and prior psoriasis or bullous pemphigoid among the sampled patients.


Of the 28,472 individuals, 2.2, 3.0, and 1.5% of the total, case, and control groups, respectively, had been diagnosed with psoriasis. After adjustments were made for patients’ monthly income, region, urbanization level, diabetes, hyperlipidemia, hypertension, and coronary heart disease, the odds ratio (OR) of diagnosed psoriasis for the case group was 1.46 (95% confidence interval [CI] 1.23–1.73; p < 0.001) compared with the control group. The ORs of a previous psoriasis diagnosis with arthritis and without arthritis in the case group were, respectively, 1.95 and 1.44 times (95% CI 1.03–3.89 and 1.21–1.72, respectively) those of the control group after adjustments for socioeconomic variables, diabetes, hyperlipidemia, hypertension, and coronary heart disease. However, no significant differences in prior bullous pemphigoid were observed between the dementia and control groups (0.5% and 0.4%, respectively).


More patients with dementia had prior psoriasis than did patients in the control group. Additional research is required to confirm our results and clarify the relationship.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Dementia Guideline Development Group. Dementia—The NICE-Scie Guideline on supporting people with dementia and their carers in health and social care. London: The British Psychological Society, The Royal College of Psychiatrists. 2007. Accessed at 21 Oct 2018.

  2. Sicras A, Rejas J, Arco S, Flores E, Ortega G, Esparcia A, et al. Prevalence, resource utilization and costs of vascular dementia compared to Alzheimer’s dementia in a population setting. Dement Geriatr Cogn Disord. 2005;19(5–6):305–15.

    Article  CAS  PubMed  Google Scholar 

  3. Jorm AF, Jolley D. The incidence of dementia: a meta-analysis. Neurology. 1998;51(3):728–33.

    Article  CAS  PubMed  Google Scholar 

  4. Leys D, Pasquier F, Parnetti L. Epidemiology of vascular dementia. Haemostasis. 1998;28(3–4):134–50.

    CAS  PubMed  Google Scholar 

  5. Perkins P, Annegers JF, Doody RS, Cooke N, Aday L, Vernon SW. Incidence and prevalence of dementia in a multiethnic cohort of municipal retirees. Neurology. 1997;49(1):44–50.

    Article  CAS  PubMed  Google Scholar 

  6. Lee MG, Kim TG, Kim DS, Kim HP. The pathophysiological role of dendritic cell subsets in psoriasis. BMB Rep. 2014;47(2):60–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Nestle FO, Kaplan DH, Barker J. Psoriasis. N Engl J Med. 2009;361(5):496–509.

    Article  CAS  Google Scholar 

  8. Abuabara K, Azfar RS, Shin DB, Neimann AL, Troxel AB, Gelfand JM. Cause-specific mortality in patients with severe Psoriasis: a population-based cohort study in the UK. Br J Dermatol. 2010;163(3):586–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Gisondi P, Sala F, Alessandrini F, Avesani V, Zoccatelli G, Beltramello A, et al. Mild cognitive impairment in patients with moderate to severe chronic plaque psoriasis. Dermatology. 2014;228(1):78–85.

    Article  PubMed  Google Scholar 

  10. Gottlieb AB, Dann F. Comorbidities in patients with psoriasis. Am J Med. 2009;122(12):e1151–9.

    Article  Google Scholar 

  11. Kimball AB, Gladman D, Gelfand JM, Gordon K, Horn EJ, Korman NJ, et al. National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening. J Am Acad Dermatol. 2008;58(6):1031–42.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Langley RG, Krueger GG, Griffiths CE. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005;64(Suppl 2):ii18–23 (discussion ii24–15).

    PubMed  PubMed Central  Google Scholar 

  13. Van Voorhees AS, Fried R. Depression and quality of life in psoriasis. Postgrad Med. 2009;121(4):154–61.

    Article  PubMed  Google Scholar 

  14. Wotton CJ, Goldacre MJ. Associations between specific autoimmune diseases and subsequent dementia: retrospective record-linkage cohort study, UK. J Epidemiol Community Health. 2017;71(6):576–83.

    Article  PubMed  Google Scholar 

  15. Innamorati M, Quinto RM, Imperatori C, Lora V, Graceffa D, Fabbricatore M, et al. Health-related quality of life and its association with alexithymia and difficulties in emotion regulation in patients with psoriasis. Compr Psychiatry. 2016;70:200–8.

    Article  PubMed  Google Scholar 

  16. Innamorati M, Quinto RM, Lester D, Iani L, Graceffa D, Bonifati C. Cognitive impairment in patients with psoriasis: a matched case–control study. J Psychosom Res. 2018;105:99–105.

    Article  PubMed  Google Scholar 

  17. Marek-Józefowicz L, Jaracz M, Placek W, Czajkowski R, Borkowska A. Cognitive impairment in patients with severe psoriasis. Postepy Dermatol Alergol. 2017;34(2):120–5.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Pompili M, Innamorati M, Forte A, Erbuto D, Lamis DA, Narcisi A, et al. Psychiatric comorbidity and suicidal ideation in psoriasis, melanoma and allergic disorders. Int J Psychiatry Clin Pract. 2017;21(3):209–14.

    Article  PubMed  Google Scholar 

  19. Pompili M, Innamorati M, Trovarelli S, Narcisi A, Bellini S, Orsini D, et al. Suicide risk and psychiatric comorbidity in patients with psoriasis. J Int Med Res. 2016;44(1 suppl):61–6.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Bartkiewicz P, Gornowicz-Porowska J, Pietkiewicz PP, Świrkowicz A, Bowszyc-Dmochowska M, Dmochowski M. Neurodegenerative disorders, bullous pemphigoid and psoriasis: a comparative study in ethnic poles indicates that Parkinson’s disease is more relevant to bullous pemphigoid. Postepy Dermatol Alergol. 2017;34(1):42–6.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Chen YC, Yeh HY, Wu JC. Taiwan’s National Health Insurance Research Database: administrative health care database as study object in bibliometrics. Scientometrics. 2011;86(2):365–80.

    Article  Google Scholar 

  22. Cheng CL, Kao YH, Lin SJ, Lee CH, Lai ML. Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf. 2011;20(3):236–42.

    Article  PubMed  Google Scholar 

  23. Yang YW, Kang JH, Lin HC. Increased risk of psoriasis following obstructive sleep apnea: a longitudinal population-based study. Sleep Med. 2012;13(3):285–9.

    Article  PubMed  Google Scholar 

  24. Lueg G, Gross CC, Lohmann H, Johnen A, Kemmling A, Deppe M, et al. Clinical relevance of specific T-cell activation in the blood and cerebrospinal fluid of patients with mild Alzheimer’s disease. Neurobiol Aging. 2015;36(1):81–9.

    Article  CAS  PubMed  Google Scholar 

  25. Banchereau J, Briere F, Caux C, Davoust J, Lebecque S, Liu YJ, et al. Immunobiology of dendritic cells. Annu Rev Immunol. 2000;18:767–811.

    Article  CAS  PubMed  Google Scholar 

  26. Manuel SL, Rahman S, Wigdahl B, Khan ZK, Jain P. Dendritic cells in autoimmune diseases and neuroinflammatory disorders. Front Biosci. 2007;12:4315–35.

    Article  CAS  PubMed  Google Scholar 

  27. Abrams JR, Kelley SL, Hayes E, Kikuchi T, Brown MJ, Kang S, et al. Blockade of T lymphocyte costimulation with cytotoxic T lymphocyte-associated antigen 4-immunoglobulin (CTLA4Ig) reverses the cellular pathology of psoriatic plaques, including the activation of keratinocytes, dendritic cells, and endothelial cells. J Exp Med. 2000;192(5):681–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Ciaramella A, Bizzoni F, Salani F, Vanni D, Spalletta G, Sanarico N, et al. Increased pro-inflammatory response by dendritic cells from patients with Alzheimer’s disease. J Alzheimers Dis. 2010;19(2):559–72.

    Article  PubMed  Google Scholar 

  29. Brenaut E, Barnetche T, Misery L. Alcohol consumption: is it really a risk factor for psoriasis? J Dermatol. 2013;40(6):508.

    Article  PubMed  Google Scholar 

  30. Carrascosa JM, Vilavella M, Garcia-Doval I, Carretero G, Vanaclocha F, Daudén E, et al. Body mass index in patients with moderate-to-severe psoriasis in Spain and its impact as an independent risk factor for therapy withdrawal: results of the Biobadaderm Registry. J Eur Acad Dermatol Venereol. 2014;28(7):907–14.

    Article  CAS  PubMed  Google Scholar 

  31. Stirland LE, O’Shea CI, Russ TC. Passive smoking as a risk factor for dementia and cognitive impairment: systematic review of observational studies. Int Psychogeriatr. 2017;18:1–11.

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Hung-Wen Chiu.

Ethics declarations


No sources of funding were used to conduct this study or prepare this manuscript.

Conflict of Interest

Ching-Chun Lin, Herng-Ching Lin, and Hung-Wen Chiu have no conflicts of interest that are directly relevant to the content of this article.

Ethical approval

The datasets used in this study contain deidentified secondary data with anonymous numbers from the Taiwan National Health Research Institute. This study was exempt from full review and approved by the Institutional Review Board of Taipei Medical University.

Informed consent

This study used deidentified secondary data that have been released by the NHI research database to the public for research purposes. Personal data were encrypted and patient privacy was protected in this research; therefore, written informed consent from the participants was not necessary.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, CC., Lin, HC. & Chiu, HW. Association Between Psoriasis and Dementia: A Population-Based Case–Control Study. Am J Clin Dermatol 20, 457–463 (2019).

Download citation

  • Published:

  • Issue Date:

  • DOI: