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TOPLINE: 

The odds of having cognitive impairment may be increased among children with atopic dermatitis (AD), primarily among those with neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) or a learning disability. 

METHODOLOGY:

• It remains unknown whether subpopulations of children with AD face a greater risk for cognitive impairment or not.
• To determine the association, researchers drew from a weighted sample of 69,732,807 children with AD in the 2021 US National Health Interview Survey.
• Main outcomes of interest were difficulty in learning or memory (cognitive impairment symptoms) as reported by the child's caregiver.
• The researchers performed logistic regression to compare the odds of learning or memory difficulties between 60,509,794 children without AD and 9,223,013 children with AD.

TAKEAWAY:

• Children with vs without AD were more likely to experience difficulties with learning (10.8% [95% CI, 7.8%-15.8%] vs 5.9% [95% CI, 5.1%-6.9%]; P < .001) and difficulties with memory (11.1% [95% CI, 8.0%-15.9%] vs 5.8% [95% CI, 4.9%-6.9%]; P < .001).
• On multivariable logistic regression adjusted for sociodemographic factors, asthma, food allergies, and seasonal allergies or hay fever, researchers found that having AD was associated with increased odds of difficulties in learning (adjusted odds ratio [AOR], 1.77; 95% CI, 1.28-2.45) and memory (AOR, 1.69; 95% CI, 1.19-2.41). 
• When stratified by neurodevelopmental comorbidities, having AD was associated with a 2- to 3-fold greater odds of memory difficulties among children with any neurodevelopmental disorder (AOR, 2.26; 95% CI, 1.43-3.57), which included ADHD (AOR, 2.90; 95% CI, 1.60-5.24) or learning disabilities (AOR, 2.04; 95% CI, 1.04-4.00).
• Having AD was not associated with learning or memory difficulties among children without neurodevelopmental conditions. 

IN PRACTICE:

"These findings may improve the risk stratification of children with AD for cognitive impairment and suggest that evaluation for cognitive impairment should be prioritized among children with AD and comorbid ADHD or learning disability," the authors wrote.

SOURCE:

Corresponding author Joy Wan, MD, of the department of dermatology at Johns Hopkins University School of Medicine, Baltimore, Maryland, and colleagues conducted the research, which was published on March 6, 2024, in JAMA Dermatology.

LIMITATIONS:

The study's limitations were its cross-sectional design, reliance on caregiver reports, and the fact that National Health Interview Survey data do not include information on factors such as AD severity, age at AD diagnosis, and sleep. 

DISCLOSURES:

The study was supported by a grant from the National Institutes of Health. Dr Wan reported receiving a grant from Pfizer and personal fees from Sun Pharmaceutical Industries and Janssen Pharmaceuticals outside the submitted work. No other study authors had disclosures to report.