Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Insititute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Respir Res. 2020 Feb 3;21(1):40. doi: 10.1186/s12931-020-1305-6.
Cognitive and motor-performance decline with age and the process is accelerated by decline in general health. In this study, we aimed to estimate the effects of COPD and HB levels on cognitive and motor performance in the general older population and assess potential interaction.
The English Longitudinal Study of Aging is a population-based cohort study including measurements of lung-function and HB levels together with cognitive and motor performance testing. Data were collected from 5709 participants including three measurement time over eight years. COPD was defined using lung-function-parameters and clinical symptoms. HB was assessed continuously and low HB was defined using clinical anemia cutoffs. Linear mixed-effects regression models were used to quantify the associations of COPD and HB with outcome measures, both individually and in combination.
Participants with both low HB and COPD demonstrated worse motor performance compared to individuals with only one exposure, resulting in up to 1 s (95%CI, 0.04-1.8) longer time needed to complete the five times sit to stand task than what would be expected based on purely additive effects. Additionally in individuals with COPD, the time to complete the motor-performance task per unit decrease in continuous HB levels was longer than in participants without COPD after full adjustment for confounding (up to 1.38 s/unit HB level, 95% CI: 0.65-2.11).
In persons with COPD low HB levels may contribute to low motor-performance in a supra additive fashion. Further studies should re-evaluate whether earlier treatment of lower HB in these individuals might be beneficial.
认知和运动表现随着年龄的增长而下降，一般健康状况的下降会加速这一过程。在这项研究中，我们旨在评估 COPD 和 HB 水平对一般老年人群认知和运动表现的影响，并评估潜在的相互作用。
英国老龄化纵向研究是一项基于人群的队列研究，包括肺功能和 HB 水平的测量以及认知和运动表现测试。数据来自 5709 名参与者，包括 8 年中的三次测量。COPD 使用肺功能参数和临床症状来定义。HB 连续评估，使用临床贫血切点定义低 HB。线性混合效应回归模型用于量化 COPD 和 HB 与结局指标的个体和联合关联。
与仅有一项暴露的个体相比，同时患有低 HB 和 COPD 的参与者的运动表现更差，导致完成五次坐立起身任务所需的时间比仅根据累加效应预计的时间延长了 1 秒（95%CI：0.04-1.8）。此外，在 COPD 患者中，与没有 COPD 的参与者相比，连续 HB 水平每降低一个单位，完成运动表现任务所需的时间更长，经过完全调整混杂因素后，增加了 1.38 秒/单位 HB 水平（95%CI：0.65-2.11）。
在患有 COPD 的人群中，低 HB 水平可能以超相加的方式导致运动表现下降。进一步的研究应重新评估这些个体中早期治疗低 HB 是否有益。
