Li Xu, Li Lin, Ji Shuming, Peng Anjiao, Chen Lei
Department of Clinical Research and Management, Center of Biostatistics, Design, Measurement and Evaluation (CBDME), West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, P. R. China.
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
BMC Pulm Med. 2024 Dec 20;24(1):626. doi: 10.1186/s12890-024-03403-0.
Despite the significant prevalence of chronic obstructive pulmonary disease (COPD) in Southwest China, cognitive function among middle-aged and elderly individuals in this area surpasses the national average. This study aims to reveal the overall pulmonary ventilation function status of this population, and investigate whether pulmonary ventilation dysfunction is a risk factor for mild cognitive impairment (MCI) in this region, as suggested by previous researches.
Data were obtained from the 2019-2021 baseline survey of a natural population cohort study conducted in Southwest China. Pulmonary function was tested by experienced and well-trained medical personnel using a spirometer. The Mini-Mental State Examination was used to evaluate cognitive function. Subsequently, multiple logistic regression analysis was employed to examine the associations between pulmonary function and cognitive levels.
A total of 2,337 middle-aged and elderly adults were included in this study, with 10.18% (238 individuals) classified as having mild cognitive impairment. According to the Chinese experts' consensus on the standardization of adult lung function diagnosis, approximately 41.16% (962/2,337) of middle-aged and elderly individuals in Southwest China suffer from pulmonary ventilation dysfunction, predominantly mild (37.53%, 877/2,337), with the primary type being obstructive ventilation dysfunction (38.60%, 902/2,337; COPD: 14.21%, 332 participants). And 81.56% participants (1,906/2,337) were found to have small airway dysfunction. Multiple logistic regression analyses showed that individuals with poor pulmonary ventilation function (PPF) were associated with an increased risk of MCI (OR [95% CI]: 1.38 [1.04, 1.83], P = 0.026). Moreover, the more severe the pulmonary ventilation dysfunction, the higher the risk of cognitive impairment (P for trend = 0.009). Similar association were found between PPF and MCI when we use ATS/ERS technical standards. No significant association was observed between small airway dysfunction and cognitive impairment (OR [95% CI]: 1.05 [0.72, 1.56], P = 0.819).
The pulmonary function status of middle-aged and elderly individuals in Southwest China requires attention, particularly regarding obstructive pulmonary ventilation dysfunction. We recommend integrating pulmonary health assessments into routine care for these populations to raise awareness of lung health, improve lung function, and ultimately enhance cognitive function.
尽管慢性阻塞性肺疾病（COPD）在我国西南地区的患病率较高，但该地区中老年人的认知功能超过全国平均水平。本研究旨在揭示该人群的整体肺通气功能状况，并调查肺通气功能障碍是否如先前研究所暗示的那样，是该地区轻度认知障碍（MCI）的危险因素。
数据来自于2019 - 2021年在中国西南地区进行的一项自然人群队列研究的基线调查。肺功能由经验丰富且训练有素的医务人员使用肺活量计进行检测。采用简易精神状态检查表评估认知功能。随后，运用多因素逻辑回归分析来检验肺功能与认知水平之间的关联。
本研究共纳入2337名中老年人，其中10.18%（238人）被归类为患有轻度认知障碍。根据中国专家关于成人肺功能诊断标准化的共识，我国西南地区约41.16%（962/2337）的中老年人存在肺通气功能障碍，主要为轻度（37.53%，877/2337），主要类型为阻塞性通气功能障碍（38.60%，902/2337；COPD：14.21%，332名参与者）。并且发现81.56%的参与者（1906/2337）存在小气道功能障碍。多因素逻辑回归分析表明，肺通气功能差（PPF）的个体发生MCI的风险增加（OR[95%CI]：1.38[1.04，1.83]，P = 0.026）。此外，肺通气功能障碍越严重，认知障碍的风险越高（趋势P = 0.009）。当我们使用ATS/ERS技术标准时，在PPF和MCI之间发现了类似的关联。未观察到小气道功能障碍与认知障碍之间存在显著关联（OR[95%CI]：1.05[0.72，1.56]，P = 0.819）。
我国西南地区中老年人的肺功能状况值得关注，尤其是阻塞性肺通气功能障碍。我们建议将肺部健康评估纳入这些人群的常规护理中，以提高对肺部健康的认识，改善肺功能，并最终增强认知功能。
