TianJin Fourth Center Hospital, Tianjin, China.
Tianjin Medical University, Tianjin, China.
BMJ Open Respir Res. 2024 Nov 28;11(1):e001709. doi: 10.1136/bmjresp-2023-001709.
Cognitive impairment is affecting plenty of patients with chronic obstructive pulmonary disease (COPD), and it is the main leading cause of quality of life to varying degrees. However, there are still wide discrepancies in these prevalence rates can be attributed to the diversity in study designs, participant age ranges, inclusion criteria and the methodologies used for assessment. Previous studies revealed the association between COPD and cognitive impairment, but the conclusions remain controversial.
The current systematic review aimed to investigate whether COPD is an independent risk factor for cognitive impairment.
A systematic review and meta-analysis.
PubMed, Cochrane Library, MEDLINE, Embase, Web of Science, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Database and Weipu Database were searched from inception to 1 December 2022.
The inclusion criteria involved studies that reported cognitive impairment in COPD. We just included cohort designs, published in English or Chinese language.
Two reviewers independently extracted and assessed the quality of data using Newcastle-Ottawa Quality Assessment Scale. The outcomes were assessed with random-effects model and reported as the HR with 95% CI using the Review Manager software.
12 studies from 10 articles reporting on 625 644 people were included. The findings indicated that compared with those without COPD at baseline, patients with COPD were associated with an increased risk of cognitive impairment. Subgroup analysis showed the association was not significantly different in sex and age, and the subgroup supports that COPD has a higher risk of non-amnestic mild cognitive impairment (na-MCI) than amnestic MCI.
Patients with COPD have a higher risk of developing cognitive impairment and are more likely to cause na-MCI compared with those without COPD, and this risk is not affected by gender or age. Therefore, continuous monitoring of cognitive function in COPD is critical.
CRD42021285913.
认知障碍影响着大量慢性阻塞性肺疾病（COPD）患者，且在不同程度上是导致生活质量下降的主要原因。然而，由于研究设计、参与者年龄范围、纳入标准和评估方法的多样性，这些患病率仍存在很大差异。先前的研究表明 COPD 与认知障碍之间存在关联，但结论仍存在争议。
本系统评价旨在探讨 COPD 是否是认知障碍的独立危险因素。
系统评价和荟萃分析。
从建库至 2022 年 12 月 1 日，检索了 PubMed、Cochrane 图书馆、MEDLINE、Embase、Web of Science、中国知识资源总库、万方数据库、中国生物医学文献数据库和维普数据库。
纳入 COPD 患者认知障碍报告的研究。仅纳入队列设计，以英文或中文发表。
两名评审员独立提取和评估数据质量，使用 Newcastle-Ottawa 质量评估量表。使用 Review Manager 软件评估结局，采用随机效应模型，并以 95%CI 报告 HR。
共纳入 10 篇文献中的 12 项研究，涉及 625644 人。结果表明，与基线时无 COPD 的患者相比，COPD 患者发生认知障碍的风险增加。亚组分析显示，在性别和年龄方面，这种关联无显著差异，且亚组分析支持 COPD 发生非遗忘型轻度认知障碍（na-MCI）的风险高于遗忘型 MCI。
与无 COPD 的患者相比，COPD 患者发生认知障碍和 na-MCI 的风险更高，且这种风险不受性别或年龄的影响。因此，对 COPD 患者的认知功能进行持续监测至关重要。
PROSPERO 注册号：CRD42021285913。
