TY - JOUR
T1 - The presence of emphysema on chest imaging and mid-life cognition
AU - Henkle, Benjamin E.
AU - Colangelo, Laura A.
AU - Dransfield, Mark T.
AU - Hou, Lifang
AU - Jacobs, David R.
AU - Joyce, Brian T.
AU - Pistenmaa, Carrie L.
AU - Putman, Rachel K.
AU - Sidney, Steve
AU - Thyagarajan, Bharat
AU - Washko, George R.
AU - Yaffe, Kristine
AU - Kalhan, Ravi
AU - Kunisaki, Ken M.
N1 - Publisher Copyright:
© 2021, European Respiratory Society. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: Airflow obstruction is associated with cognitive dysfunction but studies have not assessed how emphysema, a structural phenotype of lung disease, might be associated with cognitive function independent from pulmonary function measured by spirometry. We aimed to determine the relationship between the presence of visually detectable emphysema on chest computed tomography (CT) imaging and cognitive function. Methods: We examined 2491 participants, mean age of 50 years, from the Coronary Artery Risk Development in Young Adults study who were assessed for the presence of emphysema on chest CT imaging and had cognitive function measured 5 years later with a battery of six cognitive tests. Results: Of those assessed, 172 (7%) had emphysema. After adjusting for age, sex, height, study centre, race, body mass index, education and smoking, visual emphysema was significantly associated with worse performance on most cognitive tests. Compared to those without emphysema, participants with emphysema performed worse on cognitive testing: 0.39 SD units lower (95% CI −0.53– −0.25) on the Montreal Cognitive Assessment, 0.27 SD units lower (95% CI −0.42– −0.12) on the Rey Auditory Verbal Learning Test, 0.29 SD units lower (95% CI −0.43– −0.14) on the Digit Symbol Substitution Test and 0.25 SD units lower (95% CI −0.42– −0.09) on letter fluency. Further adjustment for forced expiratory volume in 1 s (FEV1), peak FEV1 and annualised FEV1 decline did not attenuate these associations. Conclusions: The presence of emphysema on chest CT is associated with worse cognitive function, independent of airflow obstruction. These data suggest that emphysema may be a novel risk factor for cognitive impairment.
AB - Background: Airflow obstruction is associated with cognitive dysfunction but studies have not assessed how emphysema, a structural phenotype of lung disease, might be associated with cognitive function independent from pulmonary function measured by spirometry. We aimed to determine the relationship between the presence of visually detectable emphysema on chest computed tomography (CT) imaging and cognitive function. Methods: We examined 2491 participants, mean age of 50 years, from the Coronary Artery Risk Development in Young Adults study who were assessed for the presence of emphysema on chest CT imaging and had cognitive function measured 5 years later with a battery of six cognitive tests. Results: Of those assessed, 172 (7%) had emphysema. After adjusting for age, sex, height, study centre, race, body mass index, education and smoking, visual emphysema was significantly associated with worse performance on most cognitive tests. Compared to those without emphysema, participants with emphysema performed worse on cognitive testing: 0.39 SD units lower (95% CI −0.53– −0.25) on the Montreal Cognitive Assessment, 0.27 SD units lower (95% CI −0.42– −0.12) on the Rey Auditory Verbal Learning Test, 0.29 SD units lower (95% CI −0.43– −0.14) on the Digit Symbol Substitution Test and 0.25 SD units lower (95% CI −0.42– −0.09) on letter fluency. Further adjustment for forced expiratory volume in 1 s (FEV1), peak FEV1 and annualised FEV1 decline did not attenuate these associations. Conclusions: The presence of emphysema on chest CT is associated with worse cognitive function, independent of airflow obstruction. These data suggest that emphysema may be a novel risk factor for cognitive impairment.
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U2 - 10.1183/23120541.00048-2021
DO - 10.1183/23120541.00048-2021
M3 - Article
C2 - 33748259
AN - SCOPUS:85114068098
SN - 2312-0541
VL - 7
JO - ERJ Open Research
JF - ERJ Open Research
IS - 1
M1 - 00048-2021
ER -