Abstract
Objective
To investigate the association of chronic obstructive pulmonary disease (COPD) with
mild cognitive impairment (MCI) and MCI subtype: amnestic MCI and nonamnestic MCI,
in a population-based study of elderly patients.
Patients and Methods
Participants included 1927 individuals aged 70 to 89 years enrolled in the population-based
Mayo Clinic Study of Aging. Participants were evaluated by using a nurse assessment,
neurological evaluation, and neuropsychological testing, and the diagnosis of MCI
was made by a consensus panel according to the standardized criteria. Chronic obstructive
pulmonary disease was identified by the review of medical records. The study was conducted
from October 1, 2004, through July 31, 2007. The associations of COPD and disease
duration with MCI and its subtypes were evaluated by using logistic regression models
adjusted for potential covariates.
Results
Of 1927 participants, 288 had COPD (men vs women: 18% vs 12%; P<.001). As compared with patients without COPD, patients with COPD had a higher prevalence
of MCI (27% vs 15%; P<.001). The odds ratio (OR) for MCI was almost 2 times higher in patients with COPD
than in those without (OR, 1.87; 95% CI, 1.34-2.61), with a similar effect in men
and women. The OR for MCI increased from 1.60 (95% CI, 0.97-2.57) in patients with
a COPD duration of 5 years or less to 2.10 (95% CI, 1.38-3.14) in patients with a
COPD duration of more than 5 years.
Conclusion
This population-based study suggests that COPD is associated with increased odds of
having MCI and its subtypes. There was a dose-response relationship with the duration
of COPD after controlling for the potential covariates.
Abbreviations and Acronyms:
a-MCI (amnestic mild cognitive impairment), APOE (apolipoprotein E), BMI (body mass index), CAD (coronary artery disease), COPD (chronic obstructive pulmonary disease), EMR (electronic medical record), ICD-9 (International Classification of Diseases, Ninth Revision), MCI (mild cognitive impairment), MCSA (Mayo Clinic Study of Aging), na-MCI (nonamnestic mild cognitive impairment), OMC (Olmsted Medical Center), OR (odds ratio), REP (Rochester Epidemiology Project)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Mayo Clinic ProceedingsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- 2012 Alzheimer's disease facts and figures.Alzheimers Dement. 2012; 8: 131-168
- Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset.Am J Public Health. 1998; 88: 1337-1342
- Current concepts in mild cognitive impairment.Arch Neurol. 2001; 58: 1985-1992
- Mild cognitive impairment as a diagnostic entity.J Intern Med. 2004; 256: 183-194
- Mild cognitive impairment: ten years later.Arch Neurol. 2009; 66: 1447-1455
- The Mayo Clinic Study of Aging: design and sampling, participation, baseline measures and sample characteristics.Neuroepidemiology. 2008; 30: 58-69
- Association of duration and severity of diabetes mellitus with mild cognitive impairment.Arch Neurol. 2008; 65: 1066-1073
- Burden and clinical features of chronic obstructive pulmonary disease (COPD).Lancet. 2004; 364: 613-620
- Global burden of COPD: systematic review and meta-analysis.Eur Respir J. 2006; 28: 523-532
- Lifetime risk of developing chronic obstructive pulmonary disease: a longitudinal population study.Lancet. 2011; 378: 991-996
- Cognitive function in COPD.Eur Respir J. 2010; 35: 913-922
- Neuropsychologic findings in hypoxemic chronic obstructive pulmonary disease.Arch Intern Med. 1982; 142: 1470-1476
- The Clinical Dementia Rating (CDR): current version and scoring rules.Neurology. 1993; 43: 2412-2414
- The short test of mental status. Correlations with standardized psychometric testing.Arch Neurol. 1991; 48: 725-728
- Members of the UPDRS Development Committee. Unified Parkinson's Disease Rating Scale.in: Recent Developments in Parkinson's Disease. Vol 2. Macmillan Health Care Information, Florham Park, NJ1987: 153-163
- Mayo's Older Americans Normative Studies: WAIS-R norms for ages 56 to 97.Clin Neuropsychol. 1992; 6: 1-30
- Prevalence of mild cognitive impairment is higher in men: the Mayo Clinic Study of Aging.Neurology. 2010; 75: 889-897
- Derivation and validation of automated electronic search strategies to extract Charlson comorbidities from electronic medical records.Mayo Clin Proc. 2012; 87: 817-824
- History of the Rochester Epidemiology Project.Mayo Clin Proc. 1996; 71: 266-274
- Use of a medical records linkage system to enumerate a dynamic population over time: the Rochester Epidemiology Project.Am J Epidemiol. 2011; 173: 1059-1068
- Derivation and validation of automated electronic search strategies to identify pertinent risk factors for postoperative acute lung injury.Mayo Clin Proc. 2011; 86: 382-388
- Evaluation of digital signature of Charlson comorbidities using automatic electronic note search strategies in critically ill patients.Crit Care Med. 2011; 39: 160
- The validity of using ICD-9 codes and pharmacy records to identify patients with chronic obstructive pulmonary disease.BMC Health Serv Res. 2011; 11: 37
- Coefficient of agreement for nominal scales educational and psychological measurement.Educ Psychol Meas. 1960; 20: 37-46
- Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients.J Pers Assess. 1996; 67: 588-597
- The evaluation of cognitive impairment and relevant factors in patients with chronic obstructive pulmonary disease.Respiration. 2013; 85: 98-105
- Neuropsychological deficits among patients with chronic obstructive pulmonary disease.Int J Neurosci. 1982; 16: 99-105
- Cognitive dysfunction in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (COPD).Chest. 2013; 144: 119-127
- Cognitive impairment in chronic obstructive pulmonary disease—a neuropsychological and SPECT study.J Neurol. 2003; 250: 325-332
- Chronic obstructive pulmonary disease and asthma and the risk of mild cognitive impairment and dementia: a population based CAIDE study.Curr Alzheimer Res. 2013; 10: 549-555
- Mild cognitive impairment in moderate to severe chronic obstructive pulmonary disease: a preliminary study.Chest. 2012; 142: 1516-1523
- The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease.Alzheimers Dement. 2011; 7: 270-279
- Undertreatment of COPD: a retrospective analysis of US managed care and Medicare patients.Int J Chron Obstruct Pulmon Dis. 2012; 7: 1-9
- Critical threshold cerebral hypoperfusion causes Alzheimer's disease?.Acta Neuropathol. 1999; 98: 1-8
- Cardiac disease associated with increased risk of nonamnestic cognitive impairment: stronger effect on women.JAMA Neurol. 2013; 70: 374-382
- Chronic obstructive pulmonary disease.N Engl J Med. 2000; 343: 269-280
- The role of peripheral inflammatory markers in dementia and Alzheimer's disease: a meta-analysis.J Gerontol A Biol Sci Med Sci. 2013; 68: 433-440
- Prevalence, severity and underdiagnosis of COPD in the primary care setting.Thorax. 2008; 63: 402-407
- International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study.Lancet. 2007; 370: 741-750
- The coexistence of asthma and chronic obstructive pulmonary disease (COPD): prevalence and risk factors in young, middle-aged and elderly people from the general population.PLoS One. 2013; 8: e62985
- COPD Surveillance—United States, 1999-2011.Chest. 2013; 144: 284-305
- Confirmatory spirometry for adults hospitalized with a diagnosis of asthma or chronic obstructive pulmonary disease exacerbation.BMC Pulm Med. 2012; 12: 73
- Case definitions for chronic obstructive pulmonary disease.COPD. 2006; 3: 95-100
- Risk of over-diagnosis of COPD in asymptomatic elderly never-smokers.Eur Respir J. 2002; 20: 1117-1122
- Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project.Mayo Clin Proc. 2012; 87: 151-160
- Trends in the incidence and outcomes of disseminated intravascular coagulation in critically ill patients (2004-2010): A population-based study.Chest. 2013; 143: 1235-1242
Article Info
Footnotes
Grant Support: This work was supported by National Institutes of Health (NIH) grants P50 AG016574 , U01 AG006786 , K01 MH068351 , and K01 AG028573 ; by the Robert Wood Johnson Foundation ; by the Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program; by Clinical and Translational Science Award UL1 TR000135 from the National Center for Advancing Translational Sciences , a component of the NIH; and by the Rochester Epidemiology Project (grant number R01-AG034676 ; Principal Investigators: Walter A. Rocca, MD, MPH, and Barbara P. Yawn, MD, MSc). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the NIH.
Potential Competing Interests: Dr Mielke has received funding from the National Institute on Aging and the Alzheimer Drug Discovery Foundation . Dr Roberts has received research support from the National Institutes of Health and the Driskill Foundation . Dr Yawn has received funding from BI, Merck, and Forrest related to COPD, but no funding related to COPD and cognitive issues. Dr Petersen serves on scientific advisory boards for the Alzheimer's Association, the National Advisory Council on Aging, Elan/Janssen AI, Pfizer Inc (Wyeth), and GE Healthcare; receives publishing royalties from Mild Cognitive Impairment (Oxford University Press, 2003); serves as a consultant to Elan/Janssen AI and GE Healthcare; and has received research support from the National Institutes of Health/National Advisory Council on Aging .
Identification
Copyright
© 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
