Cognitive impairment in COPD: an often overlooked co-morbidity

Higbee, Daniel; Dodd, James

doi:10.1080/17476348.2020.1811090

Cited by 18 publications

(13 citation statements)

References 26 publications

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“…Our outcome GWAS was performed with global cognitive function in the general population as a continuous outcome. Much research has focused on whether lung function and lung disease causes mild cognitive impairment (MCI) [39]. Normal cognitive function and MCI exist on a spectrum, but our study is unable to fully assess whether reduced lung function or lung disease causes MCI.…”

Section: Future Researchmentioning

confidence: 87%

Lung function, COPD and cognitive function: a multivariable and two sample Mendelian randomization study

et al. 2021

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Background Observational studies show an association between reduced lung function and impaired cognition. Cognitive dysfunction influences important health outcomes and is a precursor to dementia, but treatments options are currently very limited. Attention has therefore focused on identifying modifiable risk factors to prevent cognitive decline and preserve cognition. Our objective was to determine if lung function or risk of COPD causes reduced cognitive function using Mendelian randomization (MR). Methods Single nucleotide polymorphisms from genome wide association studies of lung function and COPD were used as exposures. We examined their effect on general cognitive function in a sample of 132,452 individuals. We then performed multivariable MR (MVMR), examining the effect of lung function before and after conditioning for covariates. Results We found only weak evidence that reduced lung function (Beta − 0.002 (SE 0.02), p-value 0.86) or increased liability to COPD (− 0.008 (0.008), p-value 0.35) causes lower cognitive function. MVMR found both reduced FEV1 and FVC do cause lower cognitive function, but that after conditioning for height (− 0.03 (0.03), p-value 0.29 and − 0.01 (0.03) p-value 0.62, for FEV1 and FVC respectively) and educational attainment (− 0.03 (0.03) p-value 0.33 and − 0.01 (0.02), p-value 0.35) the evidence became weak. Conclusion We did not find evidence that reduced lung function or COPD causes reduced cognitive function. Previous observational studies are probably affected by residual confounding. Research efforts should focus on shared risk factors for reduced lung function and cognition, rather than lung function alone as a modifiable risk factor.

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Section: Future Researchmentioning

confidence: 87%

Lung function, COPD and cognitive function: a multivariable and two sample Mendelian randomization study

et al. 2021

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“…Previous studies indicate that older adults diagnosed with COPD are at higher risk of cognitive decline compared to peers without this diagnosis 13 – 15 . COPD patients with cognitive impairment have poor compliance with medication and oxygen therapy, which increases the risk of acute exacerbations 9 .…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism behind a potential accelerated cognitive decline in COPD remains unclear 15 . This work provides support for the hypothesis that arterial hypoxia and hypercapnia could be two of the main drivers of cognitive decline in COPD since cognitive deterioration, besides the normal decline observed in aging, seems to be limited in early-stage COPD patients.…”

Section: Discussionmentioning

confidence: 99%

Cognitive decline and risk of dementia in older adults after diagnosis of chronic obstructive pulmonary disease

Rosso

Månsson

Egervall

et al. 2023

npj Prim. Care Respir. Med.

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Cognitive screening has been proposed for older adults diagnosed with chronic obstructive pulmonary disease (COPD). Therefore, we examined the change over time in cognitive function and the risk of incident dementia in older adults after COPD diagnosis. A sample of 3,982 participants from the population-based cohort study Good Aging in Skåne was followed for 19 years, and 317 incident COPD cases were identified. The cognitive domains of episodic memory, executive function, and language were assessed using neuropsychological tests. Mixed models for repeated measures and a Cox model were implemented. Participants performed, on average, worse over time on all neuropsychological tests after COPD diagnosis in comparison to those without COPD, although statistical significance differences were only observed for episodic memory and language. The groups had a comparable risk of developing dementia. In conclusion, our results indicate that cognitive screening in the early stages of COPD may be of limited clinical relevance.

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“…[ 21 ] In recent publications, new approach using Mendelian Randomization (MR) which is a novel epidemiological tool for inferring causation may provide a chance to investigate this significant knowledge gap. [ 22 ] MR is a technique that may be used to circumvent the issues associated with unmeasured confounding and reverse causation that afflict standard observational epidemiology. Through the use of genetic variations as proxy for modifiable risk variables and health outcomes, MR enables causal inference.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, a study design using observational method stilll suffer from its limitation to determine a robust causality evidence between COPD and cognitive impairment primarily due to shared risk factors with smoking [21] . In recent publications, new approach using Mendelian Randomization (MR) which is a novel epidemiological tool for inferring causation may provide a chance to investigate this significant knowledge gap [22] . MR is a technique that may be used to circumvent the issues associated with unmeasured confounding and reverse causation that afflict standard observational epidemiology.…”

Section: Discussionmentioning

confidence: 99%

Risk of developing cognitive impairment on patients with chronic obstructive pulmonary disease

Simargi¹,

Mansyur²,

Turana³

et al. 2022

Medicine

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Background: The increasing number of chronic obstructive pulmonary disease (COPD) incidence has led to a great negative impact on older people's lives. This chronic disease was a critical and independent risk factor for cognitive function impairment in the elderly with mild cognitive impairment as a frequent feature. This systematic review aimed to examine the risk of developing cognitive impairment in COPD. Methods: A structured search of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guideline, with a pre-determined search strategy starting from study identification, title and abstract screening, eligibility assessment, and inclusion of relevant study. The search was conducted in PubMed and MEDLINE via EBSCOhost, with restriction to human studies. The studies from inception until January 12, 2021. Results: Five original articles were included. Most studies found that patients with COPD had a higher chance of developing cognitive impairment, especially when patients were followed up for more than 5 years. We discovered that the risk of cognitive impairment seemed to be correlated with the length of time spent following the participants, with the highest risk of cognitive impairment being identified in those who had the longest observation period. It is critical to conduct cognitive screening from the time a diagnosis of COPD is obtained and on a continuing basis in order to recognize and treat these individuals appropriately. Conclusion: There is a potential association between COPD and mild cognitive impairment. We encourage more studies to be done with higher sensitivity and specificity cognitive screening tools in the future to build better evidence and qualify to be analyzed quantitatively with meta-analysis.

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Cognitive impairment in COPD: an often overlooked co-morbidity

Cited by 18 publications

References 26 publications

Lung function, COPD and cognitive function: a multivariable and two sample Mendelian randomization study

Lung function, COPD and cognitive function: a multivariable and two sample Mendelian randomization study

Cognitive decline and risk of dementia in older adults after diagnosis of chronic obstructive pulmonary disease

Risk of developing cognitive impairment on patients with chronic obstructive pulmonary disease

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