ADHD, Author Interviews, Dermatology, JAMA, Mental Health Research / 08.03.2024
Hopkins Study Evaluates Risk of Cognitive Impairment in Children with Atopic Dermatitis
MedicalResearch.com Interview with:
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Dr. Wan[/caption]
Dr. Joy Wan M.D., M.S.C.E.
Assistant Professor of Dermatology
Johns Hopkins University School of Medicine
MedicalResearch.com: What is the background for this study?
Response: There has been a growing body of literature linking atopic dermatitis with diagnoses such as ADHD and learning disabilities, but studies focusing on symptoms of cognitive impairment (in contrast to relying on reported diagnoses as proxy measures of such) have been fewer and demonstrate inconsistent findings. Thus, we were interested in using data from this nationally representative sample of U.S. children to examine whether atopic dermatitis was associated with symptoms of learning or memory difficulties. Moreover, we wanted to examine how this relationship is influenced by known neurodevelopmental conditions to further characterize whether specific subgroups of children with atopic dermatitis are more susceptible to cognitive impairments.
Dr. Wan[/caption]
Dr. Joy Wan M.D., M.S.C.E.
Assistant Professor of Dermatology
Johns Hopkins University School of Medicine
MedicalResearch.com: What is the background for this study?
Response: There has been a growing body of literature linking atopic dermatitis with diagnoses such as ADHD and learning disabilities, but studies focusing on symptoms of cognitive impairment (in contrast to relying on reported diagnoses as proxy measures of such) have been fewer and demonstrate inconsistent findings. Thus, we were interested in using data from this nationally representative sample of U.S. children to examine whether atopic dermatitis was associated with symptoms of learning or memory difficulties. Moreover, we wanted to examine how this relationship is influenced by known neurodevelopmental conditions to further characterize whether specific subgroups of children with atopic dermatitis are more susceptible to cognitive impairments.
Kathryn Foti, PhD, MPH
Postdoctoral fellow
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
MedicalResearch.com: What is the background for this study?
Response: The Kidney Disease: Improving Global Outcomes (KDIGO) 2021 Clinical Practice Guideline for the Management of Blood Pressure (BP) in Chronic Kidney Disease (CKD) provides recommendations for the management of BP in individuals with nondialysis CKD, incorporating new evidence since the publication of its previous guideline in 2012.
The 2021 KDIGO guideline recommends a target systolic BP <120 mmHg based on standardized office BP measurement. This BP goal is largely informed by the findings of the SPRINT trial which found targeting SBP <120 mmHg compared with <140 mmHg reduced the risk of cardiovascular disease by 25% and all-cause mortality by 27%. The benefits were similar for participants with and without CKD.
In our study, we sought to examine the potential implications of the 2021 KDIGO guideline for BP lowering among US adults with CKD compared to the 2012 KDIGO guideline (target BP ≤130/80 mmHg in adults with albuminuria or ≤140/90 mmHg or under without albuminuria) and the 2017 American College of Cardiology/American Heart Association (target BP <130/80 mmHg) guideline. Additionally, we determined implications of the 2021 KDIGO guideline for angiotensin converting enzyme inhibitor (ACEi) or angiotensin II-receptor blocker (ARB) use for those with albuminuria (recommended at systolic BP ≥120 mmHg) compared to the 2012 KDIGO guideline (recommended at BP >130/80 mmHg). 
Nicholas Reed AuD[/caption]
Nicholas S. Reed, AuD
Assistant Professor | Department of Otolaryngology-Head/Neck Surgery
Core Faculty | Cochlear Center for Hearing and Public Health
Johns Hopkins University School of Medicine
Johns Hopkins University Bloomberg School of Public Health
MedicalResearch.com: What is the background for this study?
Response: This study was a true team effort. It was funded by AARP and AARP Services, INC and the research was a collaboration of representatives from Johns Hopkins University, OptumLabs, University of California – San Francisco, and AARP Services, INC. Given all of the resent research on downstream effects of hearing loss on important health outcomes such as cognitive decline, falls, and dementia, the aim was to explore how persons with hearing loss interacted with the healthcare system in terms of cost and utilization.
MedicalResearch.com: What are the main findings?
Response: Over a 10 year period, untreated hearing loss (hearing aid users were excluded from this study as they are difficult to capture in the claims database) was associated with higher healthcare spending and utilization. Specifically, over 10 years, persons with untreated hearing loss spent 46.5% more, on average, on healthcare (to the tune of approximately $22000 more) than those without evidence of hearing loss. Furthermore, persons with untreated hearing loss had 44% and 17% higher risk for 30-day readmission and emergency department visit, respectively.
Similar relationships were seen across other measures where persons with untreated hearing loss were more likely to be hospitalized and spent longer in the hospital compared to those without evidence of hearing loss. 
