Visible atopic dermatitis (AD) has a significant impact on the romantic relationships, occupational and sexual health of adult female patients in France, according to a study published in Acta Dermato Venereologica. 1
Although Alzheimer's disease often begins in childhood, researchers explained that Alzheimer's disease often persists or begins in adulthood. Despite the higher prevalence of Alzheimer's disease among boys during infancy and childhood, Alzheimer's disease is becoming more prevalent among girls during adolescence and adulthood. A recent European population-based study found a higher prevalence of adult Alzheimer's disease in women than in men (6.6% vs. 4.4%, respectively).
Alzheimer's disease also impacts each patient's quality of life, as it is “found to have the highest global disease burden of any non-malignant skin disease in disability-adjusted life years.” Therefore, Alzheimer's disease is associated with anxiety, depression, and poor mental status. Work productivity is reduced, creating an additional financial and health burden for patients1.
The researchers noted that most studies on the negative aspects of Alzheimer's disease have primarily focused on children, meaning the effects on adult women have not been adequately investigated. As a result, they will assess how Alzheimer's disease affects the daily lives of adult French female patients, especially the social, personal and professional aspects of their lives. An anonymous questionnaire was created for this purpose.
Female patient with atopic dermatitis (AD) on the back of the neck | Image credit: isavira – Stock.adobe.com
To develop the survey, researchers interviewed dermatologists and Alzheimer's patients to gather patients' perceptions, concerns, and initial data. They used this information to create a semi-structured questionnaire with closed-ended questions about the impact of Alzheimer's disease across different stages of women's lives.
Researchers used patient-oriented eczema measurement (POEM) to analyze the objective clinical severity of AD. POEM is a “self-assessment tool used to monitor disease activity in children and adults with AD”4. The POEM asked patients how often seven specific symptoms occurred. Sleeping, bleeding, tearing, cracked skin, itching, peeling skin, dry skin in the previous week. POEM scores range from 0 to 28, which researchers used to create mild (0-7), moderate (8-16), and severe (17-28) AD severity groups. The questionnaire asked patients to anonymously provide personal information such as age, occupation, relationship status, atopic comorbidities, and presence of Alzheimer's disease in visible and/or sensory domains.
From March to May 2022, researchers enrolled study participants from a representative sample of French adult women. 1 Eligible participant was diagnosed with AD, was 18 years of age or older, could understand French, and agreed to participate in the study. They therefore enrolled 1009 adult French women with Alzheimer's disease with a mean (SD) age of 41.8 (14.2) years.
Of the study population, 67.7% reported having AD in visible areas such as the face, neck, and hands, and 19.6% reported having AD in sensual areas such as the chest, buttocks, and genital areas. I reported that there is. According to POEM, the study population consisted of 511 women (50.5%) with mild AD, 397 women (39.3%) with moderate AD, and 101 women (10.0%) with severe AD. was.
Additionally, 719 (71.4%) women in the study population had menstrual cycles, of which 58.7% (n = 422) were premenstrual (50.6%, n = 364) and during menstruation (48.3%, n = 347). reported exacerbation of AD. Regarding pregnancy, 7.3% (n = 74) reported being worried about becoming pregnant because of Alzheimer's disease. Of this subgroup, 91% (n = 67/74) feared passing on AD to their children. Similarly, of the 92.7% (n = 935) not worried about pregnancy, 26% (n = 243/935) also expressed fear of inheriting Alzheimer's disease.
Additionally, 21.8% reported that AD interfered with past romantic relationships. This was highest among patients with Alzheimer's disease in the visible region (31.4%; P = 0.0005). Similarly, Alzheimer's disease negatively affected the sexuality of 14.3% of sexually active women in the study population, and the location of Alzheimer's disease had a significant effect. Accordingly, Alzheimer's disease negatively affected sexuality in 16.8% (P < 0.0001) of AD patients in the visual domain and 23.1% (P = 0.0001) of AD patients in the sensual domain.
Most of the study population reported being employed (n = 669; 66.3%). Of this subgroup, 20.9% (n = 140/669) faced difficulties at work due to Alzheimer's disease. As a result, 37.2% (n = 249) of women, especially those with visible AD areas, reported thinking about their AD at work (42.6%; P < 0.0001). Additionally, 210 women (31.4%) reported taking at least one day off from work to attend a doctor's appointment due to Alzheimer's disease, and 19.6% (n = 131) reported missing work due to Alzheimer's disease. I reported that I was on vacation.
The researchers acknowledged limitations, one of which is recall bias due to the retrospective and self-reported nature of the study. Additionally, the survey did not include questions regarding treatment options. Despite these limitations, the researchers suggested future treatments to healthcare professionals based on their findings.
“Particular attention should be paid to patients with AD localized to the face, neck, and hands, as they are at high risk of social exclusion,” the authors concluded. “Furthermore, these results should encourage medical professionals to ask patients with Alzheimer's disease about possible erogenous zone involvement.”
reference
Fougerousse AC, Alexandre M, Darrigade AS, et al. The impact of atopic dermatitis on the lives of adult women: A survey of 1,009 French women. Actaderm venereol. 2024;104:adv10321. doi:10.2340/actadv.v104.10321Richard MA, Paul C, Nijsten T, et al. Prevalence of the most common skin diseases in Europe: a population-based study. J Eur Acad Dermatol Venereol. 2022;36(7):1088-1096. doi:10.1111/jdv.18050Laughter MR, Maymone MBC, Mashayekhi S, et al. The global burden of atopic dermatitis: Lessons from the 1990-2017 Global Burden of Disease Study. Br J Dermatol. 2021;184(2):304-309. doi:10.1111/bjd.19580 Charman CR, Benn AJ, Williams HC. Patient-oriented eczema measurement: Development and initial validation of a new tool to measure atopic eczema severity from the patient's perspective. Archdermatol. 2004;140(12):1513-1519. doi:10.1001/archderm.140.12.1513
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