Effect of nutritional risk on cognitive function in patients with chronic obstructive pulmonary disease

Huang, Yiben; Ma, Jiedong; Jiang, Bingqian; Yang, Neng; Fu, Fangyi; Chen, Xianjing; Liu, Chunyan; Miao, Xiaqi; Mao, Huanhuan; Zheng, Rongrong; Wang, Jianbo; Ding, Keke; Zhang, Xiaodiao

doi:10.1177/0300060521990127

Cited by 3 publications

(3 citation statements)

References 32 publications

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“…Our data showed that only 28.2% of the COPD patients were at nutritional risk, which was lower than the proportions in previous studies (35.2–54.8%) ( 13 , 32 – 34 ). However, we observed that COPD was still the third leading cause of high nutritional risk in our study.…”

Section: Discussioncontrasting

confidence: 90%

High Prevalence of Nutritional Risk Among Pulmonary Patients Living on the Tibetan Plateau

Quncuo

Liu

et al. 2022

Front. Nutr.

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BackgroundNutritional risk is associated with adverse clinical outcomes and is more prevalent among pulmonology patients than among patients in other departments. High-altitude environments can affect patients with chronic respiratory diseases, but evidence of the prevalence of nutritional risk among hospitalized patients with respiratory diseases in high-altitude areas is limited. This study aimed to investigate the nutritional risk and status of inpatients with different major respiratory diagnoses permanently living on the Tibetan Plateau (≥3,000 m above sea level).MethodsIn this cross-sectional study, we consecutively recruited inpatients admitted to the Department of Respiratory and Critical Care Medicine at the Tibet Autonomous Region People's Hospital of Lhasa between November 2020 and May 2021. We used the Nutrition Risk Screening (NRS) 2002 tool to assess nutritional risk among these patients. An NRS 2002 score ≥3 points indicates nutritional risk; a score ≥5 indicates high nutritional risk. According to NRS-2002 scores, patients were divided into three groups (NRS-2002 0–2, 3–4, and ≥5). The differences in age, sex, major respiratory diagnoses, comorbidities, body mass index, and laboratory findings among the groups were analyzed.ResultsA total of 289 eligible Tibetan patients were enrolled in the study, and 46.1% (133/246) of them were at nutritional risk (NRS-2002 score ≥3). Twenty-one (7.3%) patients were at high nutritional risk (NRS-2002 score ≥5). The proportions of patients at nutritional risk were relatively high among patients with lung cancer (58.8%), interstitial lung disease (58.3%), pulmonary embolism (52.9%), and tuberculosis (50.0%). Laboratory findings showed that patients with NRS-2002 scores of 3–4 and ≥5 had lower red blood cell counts, serum albumin and hemoglobin levels, and higher C-reactive protein (CRP) levels than those with NRS-2002 scores < 3.ConclusionThe prevalence of nutritional risk was high among pulmonology department inpatients permanently living on the Tibetan Plateau. Patients with lung cancer, interstitial lung disease, pulmonary embolism or tuberculosis were more likely to have nutritional risk than patients with other diagnoses. The nutritional risk of inpatients in the respiratory department in the plateau area should not be ignored, and patients at high nutritional risk should receive timely intervention.

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Section: Discussioncontrasting

confidence: 90%

High Prevalence of Nutritional Risk Among Pulmonary Patients Living on the Tibetan Plateau

Quncuo

Liu

et al. 2022

Front. Nutr.

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“…At the same time, the study by Huang et al explores the impact of malnutrition on cognitive function, showing a negative correlation between MMSE scores and nutritional risk [ 89 ]. This emphasizes the need for nutritional assessments and interventions as an integral part of managing chronic respiratory diseases, underscoring malnutrition as an independent risk factor for cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

Interactions between Cognitive, Affective, and Respiratory Profiles in Chronic Respiratory Disorders: A Cluster Analysis Approach

Buican,

Gheorman,

Udriştoiu

et al. 2024

Diagnostics

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This study conducted at Leamna Pulmonology Hospital investigated the interrelations among cognitive, affective, and respiratory variables within a cohort of 100 patients diagnosed with chronic respiratory conditions, utilizing sophisticated machine learning-based clustering techniques. Spanning from October 2022 to February 2023, hospitalized individuals confirmed to have asthma or COPD underwent extensive evaluations using standardized instruments such as the mMRC scale, the CAT test, and spirometry. Complementary cognitive and affective assessments were performed employing the MMSE, MoCA, and the Hamilton Anxiety and Depression Scale, furnishing a holistic view of patient health statuses. The analysis delineated three distinct clusters: Moderate Cognitive Respiratory, Severe Cognitive Respiratory, and Stable Cognitive Respiratory, each characterized by unique profiles that underscore the necessity for tailored therapeutic strategies. These clusters exhibited significant correlations between the severity of respiratory symptoms and their effects on cognitive and affective conditions. The results highlight the benefits of an integrated treatment approach for COPD and asthma, which is personalized based on the intricate patterns identified through clustering. Such a strategy promises to enhance the management of these diseases, potentially elevating the quality of life and everyday functionality of the patients. These findings advocate for treatment customization according to the specific interplays among cognitive, affective, and respiratory dimensions, presenting substantial prospects for clinical advancement and pioneering new avenues for research in the domain of chronic respiratory disease management.

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“…Among others this high prevalence of undernutrition is caused by poor dietary quality and lifestyle habits, decreased dietary intake due to anorexia and early satiety, and increased energy expenditure related to circulating factors such as hormones, adipokines, and inflammatory cytokines. Undernutrition and micronutrient deficiencies have been associated with neurodegeneration, and COPD patients with increased nutritional risk are more likely to have cognitive impairment ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of a nutritional intervention on impaired behavior and cognitive function in an emphysematous murine model of COPD with endotoxin-induced lung inflammation

et al. 2022

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One cluster of the extrapulmonary manifestations in chronic obstructive pulmonary disease (COPD) is related to the brain, which includes anxiety, depression and cognitive impairment. Brain-related comorbidities are related to worsening of symptoms and increased mortality in COPD patients. In this study, a murine model of COPD was used to examine the effects of emphysema and repetitive pulmonary inflammatory events on systemic inflammatory outcomes and brain function. In addition, the effect of a dietary intervention on brain-related parameters was assessed. Adult male C57Bl/6J mice were exposed to elastase or vehicle intratracheally (i.t.) once a week on three consecutive weeks. Two weeks after the final administration, mice were i.t. exposed to lipopolysaccharide (LPS) or vehicle for three times with a 10 day interval. A dietary intervention enriched with omega-3 PUFAs, prebiotic fibers, tryptophan and vitamin D was administered from the first LPS exposure onward. Behavior and cognitive function, the degree of emphysema and both pulmonary and systemic inflammation as well as blood-brain barrier (BBB) integrity and neuroinflammation in the brain were assessed. A lower score in the cognitive test was observed in elastase-exposed mice. Mice exposed to elastase plus LPS showed less locomotion in the behavior test. The enriched diet seemed to reduce anxiety-like behavior over time and cognitive impairments associated with the presented COPD model, without affecting locomotion. In addition, the enriched diet restored the disbalance in splenic T-helper 1 (Th1) and Th2 cells. There was a trend toward recovering elastase plus LPS-induced decreased expression of occludin in brain microvessels, a measure of BBB integrity, as well as improving expression levels of kynurenine pathway markers in the brain by the enriched diet. The findings of this study demonstrate brain-associated comorbidities – including cognitive and behavioral impairments – in this murine model for COPD. Although no changes in lung parameters were observed, exposure to the specific enriched diet in this model appeared to improve systemic immune disbalance, BBB integrity and derailed kynurenine pathway which may lead to reduction of anxiety-like behavior and improved cognition.

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Effect of nutritional risk on cognitive function in patients with chronic obstructive pulmonary disease

Cited by 3 publications

References 32 publications

High Prevalence of Nutritional Risk Among Pulmonary Patients Living on the Tibetan Plateau

High Prevalence of Nutritional Risk Among Pulmonary Patients Living on the Tibetan Plateau

Interactions between Cognitive, Affective, and Respiratory Profiles in Chronic Respiratory Disorders: A Cluster Analysis Approach

Effects of a nutritional intervention on impaired behavior and cognitive function in an emphysematous murine model of COPD with endotoxin-induced lung inflammation

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