Abstract P125: The Association Between Chronic Obstructive Pulmonary Disease and Cognitive Status in an Elderly Sample Using the Third National Health and Nutrition Examination Survey
Introduction: Dementia and cognitive impairment is a major public health issue and is likely related to complex interaction between genetics and modifiable risk factors. Chronic Obstructive Pulmonary Disease (COPD) has been associated with dementia, but its relationship with specific cognitive deficits has not been previously explored.
Methods: Data was analyzed from the Third National Health and Nutrition Examination Survey (NHANES III). Cases of COPD were defined by a ratio of forced expiratory volume to forced vital capacity of < 0.7. The three cognitive tests included 1) three word immediate verbal memory test (9 points), 2) delayed verbal memory test (9 points), and 3) serial subtractions test (5 trials), as a surrogate of executive function. The odds of having poor cognitive status was assessed using logistic regression models between COPD and each of the three cognitive tests. Models were furthers adjusted for demographic variables, including age, sex, height, body mass index education, race, poverty income ratio, and medical coverage, smoking, and medical comorbidities.
Results: We identified individuals 60-89 years of age (weighted N= 17,181,182) with a diagnosis of COPD (mean age 71.5 ± 0.19 years, 50.1% women, 85.9% non-Hispanic whites). In the unadjusted model, there was a strong association between COPD and poor scores for immediate memory recall (<5 out of 9 points; OR 2.18, 95% CI 1.81-2.62), delayed memory recall (<4 out of 9 points; OR 2.25, 95% CI 1.85-2.70) and serial subtraction (< 5 trials correct; OR 1.44, 95% CI 1.10-1.90). After adjusting for socio-demographic and vascular variables, these relationships remained robust for the immediate and delayed recall tests. In contrast, the association with serial subtraction test was rendered insignificant after adjusting for socio-demographic factors (OR 1.05, 95% CI 0.69-1.60). Upon further adjusting for vascular risk factors such as stroke, coronary heart disease, hypertension, diabetes and congestive heart failure, the odds for poor serial subtraction test increased and became significant (OR 2.74, 95% CI 1.17-6.40, p trend < 0.001).
Discussion: In this nationally representative database, COPD is significantly associated with impaired immediate and delayed memory, but not with executive function. These results shed light on differential susceptibility of the brain in COPD and its relationship with vascular risk factors.
Author Disclosures: A. Sherzai: None. J.Z. Willey: None. S. Vega: None. D. Sherzai: None.
- © 2015 by American Heart Association, Inc.