Poor pulmonary function, respiratory disease tied to higher dementia risk: meta-analysis

  • Chest

  • de Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Poor pulmonary function and respiratory disease are associated with a higher risk for dementia, according to a meta-analysis of longitudinal cohort studies.

Why this matters

  • The aging of the population means the absolute number of individuals with dementia worldwide is expected to triple by 2050.
  • The etiology behind the associations is unknown and should be further evaluated but could involve decreased oxygen supply to the brain.
  • Clinicians should aggressively treat diminished pulmonary function or respiratory disease.

Study design

  • A meta-analysis of 10 longitudinal cohort studies of pulmonary function/dementia, 11 studies of respiratory disease/dementia, and 1 study that evaluated both.
  • Funding: None.

Key results

  • The lowest (vs highest) quartile of FEV1 was associated with a nonsignificant 46% increased risk for dementia:
    • Pooled HR, 1.46 (95% CI, 0.77-2.75; I2=69.3%; n=62,209 in 2 studies).
  • A decline (vs no decline) of 1 standard deviation in FEV1 was associated with a 28% higher risk for dementia:
    • Pooled HR, 1.28 (95% CI, 1.03-1.60; I2=78.2%; n=67,505 in 5 studies).
  • Respiratory disease (COPD, pulmonary disorder, asthma, pneumonia) was associated with a 54% increased risk for dementia:
    • Pooled HR, 1.54 (95% CI, 1.30-1.81; I2=92.4%; n=288,641 in 11 studies).

Limitations

  • Observational design.
  • Moderate to high heterogeneity across studies.