The domains of working memory, attention, inductive and abstract reasoning, executive control, processing speed, and verbal comprehension and ability were not significantly different in those with and without COPD. This analysis of a large sample suggests that COPD is non-significantly associated with the cognitive domains tested.
The sample was homogenous in terms of ResultsĪn overview of participant characteristics by lifetime COPD, for both 20, is shown in Table 1. Data were collected from graduate respondents in 1957, 1975, 1992, 2004, and 2011. The study was originally conceived to assess Wisconsin's ability to provide adequate resources to students with an interest in attending college. The initial cohort ( n = 10,317) was from a random one-third sample of all Wisconsin high school seniors graduating in 1957. The WLS is a public, de-identified, database following Wisconsin high school graduates over 54 years. To address these gaps, the present study sought to examine the relationship between COPD and multiple cognitive domains using secondary data from the Wisconsin Longitudinal Study (WLS), at two time points, seven years apart, beginning when the cohort was largely in its seventh decade of life (34). Additionally, prior studies have not explored the effects of depression on cognition in adults with COPD. To our knowledge, no large studies to date have examined performance on tests assessing multiple cognitive domains in people with COPD. Additionally, COPD is frequently associated with psychiatric disorders including depression and anxiety, which are independently associated with cognitive impairment (,, , ). Vascular dysfunction is itself linked to cognitive impairment which may be further advanced by COPD (28,29). There is also a higher prevalence of comorbid cardiovascular and cerebrovascular diseases, including atherosclerosis and stroke, in people with COPD (,, , ). Chronic systemic inflammation has been linked to cognitive impairment in middle-aged and older adults (,, ). Additionally, there is evidence of elevated inflammatory markers in patients with COPD, suggesting that systemic inflammation is another potential mechanism of brain changes in patients with this disease (19,20). concludes that non-hypoxemic patients still showed cognitive impairments (12,18). suggests cognitive impairment may be limited to those COPD patients with chronic hypoxemia, while a study by Liesker et al. Other, generally small, studies utilized more specific cognitive measures and found intelligence, learning and memory, attention, executive control, and processing speed differences between COPD patients and controls (,, ). However, a few small studies found no significant association between COPD and cognition in the elderly using global screening measures (,, ). Most of these studies found a significantly higher prevalence of cognitive impairment in COPD subjects compared to controls (,, ,, ).
Several studies have examined cognition in people with COPD, many of which used global screening measures to assess cognitive impairment and dementia. Increased age and female sex also increase COPD risk (1).ĬOPD may be associated with dementia risk (6). The most common risk factors for COPD are tobacco smoking followed by environmental exposure to pollutants (5).
The disease normally presents after 40 years of age, with over 10% of adults aged 65 and older in the US diagnosed with this life-limiting disease (4). It is the third leading cause of death in the US and mortality rates continue to increase annually (3). This disease often leads to recurrent hospitalizations for acute exacerbations and incurs a high cost burden due to patients' needs for outpatient follow-up and maintenance therapies (2). COPD is characterized by airflow limitation in the lungs due to inflammatory responses to noxious particles and is largely irreversible in its later stages (1). Chronic obstructive pulmonary disease (COPD) is a common group of chronic respiratory illnesses with increasing prevalence in the aging population.
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