Lung Function Impairment and the Risk of Incident Dementia: The Rotterdam Study

Author:

Xiao Tian1,Wijnant Sara R.A.123,Licher Silvan1,Terzikhan Natalie1,Lahousse Lies3,Ikram M. Kamran14,Brusselle Guy G.125,Ikram M. Arfan1

Affiliation:

1. Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands

2. Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium

3. Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium

4. Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands

5. Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

Abstract

Background: The etiology of dementia may partly be underpinned by impaired lung function via systemic inflammation and hypoxia. Objective: To prospectively examine the association between chronic obstructive pulmonary disease (COPD) and subclinical impairments in lung function and the risk of dementia. Methods: In the Rotterdam Study, we assessed the risk of incident dementia in participants with Preserved Ratio Impaired Spirometry (PRISm; FEV1/FVC≥0.7, FEV1 < 80% predicted) and in participants with COPD (FEV1/FVC < 0.7) compared to those with normal spirometry (controls; FEV1/FVC≥0.7, FEV1≥80% predicted). Hazard ratios (HRs) with 95% confidence intervals (CI) for dementia were adjusted for age, sex, education attainment, smoking status, systolic blood pressure, body mass index, triglycerides, comorbidities and Apolipoprotein E (APOE) genotype. Results: Of 4,765 participants, 110 (2.3%) developed dementia after 3.3 years. Compared to controls, participants with PRISm, but not COPD, had an increased risk for all-type dementia (adjusted HRPRISm 2.70; 95% CI, 1.53–4.75; adjusted HRCOPD 1.03; 95% CI, 0.61–1.74). These findings were primarily driven by men and smokers. Similarly, participants with FVC% predicted values in the lowest quartile compared to those in the highest quartile were at increased risk of all-type dementia (adjusted HR 2.28; 95% CI, 1.31–3.98), as well as Alzheimer’s disease (AD; adjusted HR 2.13; 95% CI, 1.13–4.02). Conclusion: Participants with PRISm or a low FVC% predicted lung function were at increased risk of dementia, compared to those with normal spirometry or a higher FVC% predicted, respectively. Further research is needed to elucidate whether this association is causal and how PRISm might contribute to dementia pathogenesis.

Publisher

IOS Press

Subject

Psychiatry and Mental health,Geriatrics and Gerontology,Clinical Psychology,General Medicine,General Neuroscience

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