Ray Maile, Sano Mary, Wisnivesky Juan P, Wolf Michael S, Federman Alex D
Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
J Am Geriatr Soc. 2015 Apr;63(4):684-91. doi: 10.1111/jgs.13350. Epub 2015 Apr 8.
To determine whether poor asthma control is associated with cognitive impairment in a cohort of older, inner-city adults with asthma.
Prospective observational cohort study.
Outpatient practices in New York City and Chicago.
Individuals aged 60 and older with a physician diagnosis of asthma and without chronic obstructive pulmonary disease or a smoking history of 10 pack-years or more (N = 452).
Cognitive assessments that included processing speed (pattern comparison, Trail-Making Test Part A), executive function (Trail-Making Test Part B), attention and working memory (letter number sequencing), immediate and delayed recall (Wechsler Memory Scale Story A), word fluency (animal naming), and global cognitive function (Mini-Mental State Examination) were administered. Asthma control was measured using the Asthma Control Questionnaire (ACQ) and airway obstruction using spirometry as the predicted forced expiratory volume at 1 second (FEV1) of less than 70%. Cognitive measures were modeled in linear and logistic regression models controlling for age, race, education, English proficiency, and income.
Participants had a mean age of 68; 41% had poor asthma control according to the ACQ, and 35% had FEV1 of less than 70%. Poor asthma control and FEV1 less than 70% were significantly associated with all measures of cognitive function in univariate analyses, although these associations lost their statistical significance after adjusting for age, education, English proficiency, and other covariates. The same pattern was observed when the outcomes were below-normal performance on the cognitive measures based on normative data.
Poor asthma control and airway obstruction are not associated with poor performance on various measures of cognitive function in older adults with asthma.
确定在一群年龄较大的市中心哮喘成年患者中，哮喘控制不佳是否与认知障碍相关。
前瞻性观察队列研究。
纽约市和芝加哥的门诊机构。
年龄在60岁及以上、经医生诊断患有哮喘且无慢性阻塞性肺疾病或吸烟史达10包年及以上的个体（N = 452）。
进行了认知评估，包括处理速度（模式比较、连线测验A部分）、执行功能（连线测验B部分）、注意力和工作记忆（字母数字排序）、即时和延迟回忆（韦氏记忆量表故事A）、词汇流畅性（动物命名）以及整体认知功能（简易精神状态检查表）。使用哮喘控制问卷（ACQ）测量哮喘控制情况，使用肺量计测量气道阻塞情况，以预测1秒用力呼气量（FEV1）低于70%为标准。在控制年龄、种族、教育程度、英语水平和收入的线性和逻辑回归模型中对认知测量结果进行建模。
参与者的平均年龄为68岁；根据ACQ，41%的人哮喘控制不佳，35%的人FEV1低于70%。在单变量分析中，哮喘控制不佳和FEV1低于70%与所有认知功能测量指标均显著相关，尽管在调整年龄、教育程度、英语水平和其他协变量后，这些关联失去了统计学意义。当根据规范数据将认知测量结果为低于正常表现作为结局时，观察到了相同的模式。
在患有哮喘的老年人中，哮喘控制不佳和气道阻塞与各种认知功能测量指标的不佳表现无关。
