Xie Fei, Xie Lixin
Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing 100853, China,
Int J Chron Obstruct Pulmon Dis. 2019 Feb 13;14:403-408. doi: 10.2147/COPD.S194277. eCollection 2019.
COPD may lead to cognitive impairment or even dementia. However, the current conclusions are inconsistent with little evidence from prospective, large-sample studies. This study was designed to explore the association of COPD with mild cognitive impairment (MCI) and dementia risk based on a cohort study.
All participants were from the Chinese Longitudinal Health Longevity Survey (CLHLS) 2011/2012 waves. The follow-up survey was conducted in 2014 and the incidence of MCI and dementia were recorded.
During the 3-year follow-up period, 712 new cases of MCI and 83 new cases of dementia were diagnosed. The incidence of MCI and dementia were higher in those with COPD than those without COPD at baseline. Cox analysis showed that the HRs of COPD for MCI and dementia incidence were 1.486 (95% CI: 1.207-1.855) and 1.896 (95% CI: 1.079-3.330), respectively after adjusting for related covariates. For different baseline smoking status, those who were current smokers had the highest HRs of COPD for MCI and dementia.
Baseline COPD was independently associated with increased risk of MCI and dementia incidence among Chinese elderly, and the association was more pronounced among those who were current smokers.
慢性阻塞性肺疾病（COPD）可能导致认知障碍甚至痴呆。然而，目前的结论并不一致，前瞻性大样本研究的证据很少。本研究旨在基于队列研究探讨COPD与轻度认知障碍（MCI）及痴呆风险之间的关联。
所有参与者均来自2011/2012年中国老年健康影响因素跟踪调查（CLHLS）。2014年进行了随访调查，并记录了MCI和痴呆的发病率。
在3年的随访期内，共诊断出712例新发MCI病例和83例新发痴呆病例。基线时患有COPD的患者中MCI和痴呆的发病率高于未患COPD的患者。Cox分析显示，在调整相关协变量后，COPD导致MCI和痴呆发病的风险比（HR）分别为1.486（95%置信区间：1.207 - 1.855）和1.896（95%置信区间：1.079 - 3.330）。对于不同的基线吸烟状况，当前吸烟者中COPD导致MCI和痴呆的HR最高。
基线时COPD与中国老年人MCI和痴呆发病风险增加独立相关，且这种关联在当前吸烟者中更为明显。
