Cognitive Functions Assessment in Psoriasis Patients: A Cross-sectional Study in University Hospital

Background: Psoriasis is not merely an inflammatory skin disease but is commonly associated with systemic inflammation causing medical and psychiatric comorbidities. Objectives: To investigate several cognitive domains and detect Mild Cognitive Impairment (MCI) in psoriasis patients. Methods: 100 psoriasis patients, age 80 and sex-matched controls were recruited, dermatological and psychiatric assessments were done, psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI) score. Montreal Cognitive Assessment-Basic ( MoCA- B) was used to assess the different cognitive domains and to screen for any possible MCI. Results: Cognitive functions were significantly worse in patients than in the healthy controls for the total score of MOCA-B (p <0.001), abstraction (p <0.001), delayed recall (p <0.001), visuospatial abilities (p= 0.013), naming (p=0.029) and attention (p <0.001). MCI was detected by the Arabic version of MoCA-B with a cut-off score of 21/22, and it was more in the psoriasis group (16 %) than in the controls (4%). No correlations were observed between disease characteristics (Psoriasis duration in months, PASI, BSA%,) and the MoCA scores in psoriasis patients. Conclusion: Psoriasis patients showed worse cognitive impairment when compared to the controls regardless of the psoriasis severity. Thus, the routine clinical examination of psoriasis patients should include the administration of a brief cognitive screening tool to reach the best management.