Chronic cough and chronic pruritus in older adults: a population-based cross-sectional study

Chronic pruritus (CP) and chronic cough (CC) are prevalent conditions with shared underlying mechanisms, including neuronal sensitisation and inflammation. While previous studies identified associations between pruritus and CC, limited data exist on their interplay when accounting for confounders such as smoking and asthma.

This cross-sectional study analysed middle-aged and older participants from a population-based cohort, the Rotterdam Study. Logistic regression models assessed associations between demographic and lifestyle factors (e.g. smoking), CC (categorised as new-onset or persistent based on longitudinal data), asthma, and CP, reported as odds ratios with 95% confidence intervals. Sensitivity analyses sequentially excluded participants with atopic dermatitis, asthma and a combination of atopic conditions.

In total, 4364 participants (age range 48-99 years, median age 71; 58.8% women) were included. Persistent CC was strongly associated with CP, doubling the odds in multivariable analyses (OR 2.07, 95% CI 1.43-3.00). Smoking was independently associated with CP, with the highest odds in current smokers (OR 1.46, 95% CI 1.10-1.92). The association between persistent CC and CP remained robust across all sensitivity analyses.

Persistent CC is strongly associated with CP, emphasising shared pathogenic mechanisms. Smoking emerged as a modifiable risk factor for CP. Longitudinal studies are needed to establish causality and optimise therapeutic and management strategies.