Strategies for Navigating Psoriatic Arthritis-Linked Cognitive Impairment
Brain fog and mild cognitive impairment (MCI) have been associated with psoriasis and psoriatic arthritis (PsA), conditions driven by chronic systemic inflammation. This inflammation, involving pro-inflammatory cytokines such as IL-17 and IL-23, not only affects skin and joints but may also contribute to neuroinflammation, which has been implicated in cognitive issues like brain fog and memory difficulties (Health Central, 2025).
A 2021 study reports that people with PsA had a higher rate of MCI than the general population. MCI is characterised by minor difficulties such as losing things frequently, thinking more slowly, and forgetting words or appointments.
Treating psoriatic disease with appropriate therapies, especially biologic agents targeting systemic inflammation, can potentially improve symptoms of brain fog or MCI. By reducing underlying systemic and neuroinflammation linked to psoriasis, these biologics may help alleviate cognitive symptoms connected to brain fog (Dermatology Times, 2025; CUHK study, 2025).
Biologic therapies, such as IL-23 inhibitors like tildrakizumab or IL-17 inhibitors, have demonstrated efficacy in controlling systemic inflammation in psoriatic disease. Some studies associate their use with reduced cardiovascular risk and possibly reduced neuroinflammation (Dermatology Times, 2025; CUHK study, 2025).
In patients with psoriasis and comorbid MCI, biologic treatment administered in-office has helped address challenges of adherence and cognitive decline. By managing systemic inflammation more effectively, these biologics may indirectly improve neurocognitive symptoms, though direct clinical trials focused on MCI or brain fog outcomes are lacking (Dermatology Times, 2025).
MCI itself currently lacks drug treatments, but lifestyle and trait management—including controlling systemic diseases like psoriasis—may help slow progression or improve symptoms. Given that psoriasis-related systemic inflammation can exacerbate cognitive symptoms via cytokine-driven neuroinflammation, controlling that inflammation is a rational approach to mitigating brain fog (Medical News Today, 2025).
While psoriasis and PsA can cause brain fog to occur, some comorbidities, such as depression and anxiety, may also play a role. Consistently getting restful sleep may help improve symptoms of brain fog, as alterations in sleep increases the risk of MCI, and the sleep quality of individuals with MCI was poorer than healthy participants (Medical News Today, 2025). The Arthritis Foundation suggests that factors associated with PsA, such as pain, depression, and sleep apnea, can affect a person's sleep.
In summary, treating psoriatic disease with systemic agents that reduce inflammation holds promise for improving brain fog or MCI symptoms by targeting shared inflammatory pathways. However, direct evidence on cognitive improvement remains limited, and management should also include addressing other risk factors and supportive cognitive care.
References: - Health Central (2025). Understanding the Link Between Psoriasis and Cognitive Issues. [Online] Available at: https://www.healthcentral.com/article/psoriasis-and-cognitive-issues - Dermatology Times (2025). Tildrakizumab for Psoriasis in the Elderly. [Online] Available at: https://www.dermatologytimes.com/view/tildrakizumab-for-psoriasis-in-the-elderly - CUHK study (2025). IL-17 Inhibition in Psoriatic Arthritis Repairs Joint Damage and Reduces Inflammation. [Online] Available at: https://www.cuhk.edu.hk/news/2025/03/26/01-3861-en.shtml - Medical News Today (2025). Mild Cognitive Impairment (MCI): Causes, Symptoms, Diagnosis, and Treatment. [Online] Available at: https://www.medicalnewstoday.com/articles/327421 - Arthritis Foundation (n.d.). Managing Psoriatic Arthritis: Sleep. [Online] Available at: https://www.arthritis.org/health-wellness/healthy-living/managing-your-health/managing-your-health-conditions/psoriatic-arthritis/psoriatic-arthritis-and-sleep - Mayo Clinic (n.d.). Psoriatic Arthritis. [Online] Available at: https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20356482 - Alzheimer's Society (n.d.). Mild Cognitive Impairment (MCI). [Online] Available at: https://www.alzheimers.org.uk/about-dementia/other-types-of-dementia/mild-cognitive-impairment-mci - National Sleep Foundation (n.d.). Sleep and Mild Cognitive Impairment. [Online] Available at: https://www.sleepfoundation.org/articles/sleep-and-mild-cognitive-impairment - Harvard Health Publishing (n.d.). Brain Fog. [Online] Available at: https://www.health.harvard.edu/diseases-and-conditions/brain-fog - Johns Hopkins Medicine (n.d.). Psoriasis. [Online] Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/psoriasis - American Academy of Dermatology (n.d.). Psoriasis. [Online] Available at: https://www.aad.org/public/diseases/psoriasis/what-is-psoriasis - National Psoriasis Foundation (n.d.). Psoriasis. [Online] Available at: https://www.psoriasis.org/what-is-psoriasis
- The neurological disorders associated with psoriasis, such as brain fog and mild cognitive impairment (MCI), are driven by chronic systemic inflammation, with pro-inflammatory cytokines like IL-17 and IL-23 playing a significant role.
- Biologic therapies, like IL-23 inhibitors and IL-17 inhibitors, have shown effectiveness in controlling systemic inflammation in psoriatic disease, potentially reducing neuroinflammation and improving cognitive symptoms related to brain fog.
- Psoriasis and psoriatic arthritis (PsA) can increase the risk of mild cognitive impairment (MCI), a condition characterized by minor difficulties such as frequent loss of items, slower thinking, and memory lapses.
- While treating psoriatic disease with biologics promising for improving brain fog or MCI symptoms, direct evidence on cognitive improvement remains limited, and other risk factors, such as depression and anxiety, may also contribute to cognitive symptoms.
- Consistently getting restful sleep may help alleviate symptoms of brain fog, as poor sleep quality is associated with an increased risk of MCI, and sleep issues are common in individuals with psoriasis and MCI.
- In the workplace-wellness and health-and-wellness context, addressing comorbidities like psoriasis, skin conditions, and mental health issues, such as depression and anxiety, can indirectly improve cognitive function by optimizing sleep and controlling systemic inflammation.
- Adopting a comprehensive approach to managing psoriatic disease includes skin care, fitness and exercise, mental health care, and lifestyle management to slow the progression or improve symptoms of chronic diseases like psoriasis, psoriatic arthritis, and mild cognitive impairment, as well as reduce the risk of associated neurological disorders and brain fog.
