Xia Chen, Zhenjie Yu, Yong Liu, Yang Zhao, Shu Li, Lan Wang
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Previous studies revealed the association between COPD and cognitive impairment, but the conclusions remain controversial.</p><p><strong>Objectives: </strong>The current systematic review aimed to investigate whether COPD is an independent risk factor for cognitive impairment.</p><p><strong>Study design: </strong>A systematic review and meta-analysis.</p><p><strong>Data sources: </strong>PubMed, Cochrane Library, MEDLINE, Embase, Web of Science, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Database and Weipu Database were searched from inception to 1 December 2022.</p><p><strong>Eligibility criteria: </strong>The inclusion criteria involved studies that reported cognitive impairment in COPD. We just included cohort designs, published in English or Chinese language.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers independently extracted and assessed the quality of data using Newcastle-Ottawa Quality Assessment Scale. 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引用次数: 0
摘要
背景：认知功能障碍影响着大量慢性阻塞性肺疾病（COPD）患者，并在不同程度上成为影响患者生活质量的主要原因。然而，这些患病率仍然存在很大差异，这可归因于研究设计、参与者年龄范围、纳入标准和评估方法的多样性。先前的研究揭示了COPD与认知障碍之间的联系，但结论仍然存在争议。目的：本系统综述旨在调查COPD是否是认知障碍的独立危险因素。研究设计：系统回顾和荟萃分析。数据来源：PubMed、Cochrane Library、MEDLINE、Embase、Web of Science、中国知识资源综合库、万方数据库、中国生物医学数据库、卫普数据库，检索时间为建库至2022年12月1日。入选标准：纳入标准涉及报告COPD患者认知障碍的研究。我们只纳入了用英文或中文发表的队列设计。数据提取和综合：两位审稿人使用纽卡斯尔-渥太华质量评估量表独立提取和评估数据的质量。使用随机效应模型评估结果，并使用Review Manager软件报告95% CI的HR。结果：纳入了10篇报道625644人的12项研究。研究结果表明，与基线时未患COPD的患者相比，COPD患者发生认知障碍的风险增加。亚组分析显示，这种关联在性别和年龄上没有显著差异，亚组支持COPD发生非遗忘性轻度认知障碍（na-MCI）的风险高于遗忘性MCI。结论：与非COPD患者相比，COPD患者发生认知功能障碍的风险更高，更容易发生na-MCI，且这种风险不受性别和年龄的影响。因此，持续监测COPD患者的认知功能至关重要。普洛斯彼罗注册号：CRD42021285913。
Chronic obstructive pulmonary disease as a risk factor for cognitive impairment: a systematic review and meta-analysis.
Background: Cognitive impairment is affecting plenty of patients with chronic obstructive pulmonary disease (COPD), and it is the main leading cause of quality of life to varying degrees. However, there are still wide discrepancies in these prevalence rates can be attributed to the diversity in study designs, participant age ranges, inclusion criteria and the methodologies used for assessment. Previous studies revealed the association between COPD and cognitive impairment, but the conclusions remain controversial.
Objectives: The current systematic review aimed to investigate whether COPD is an independent risk factor for cognitive impairment.
Study design: A systematic review and meta-analysis.
Data sources: PubMed, Cochrane Library, MEDLINE, Embase, Web of Science, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Database and Weipu Database were searched from inception to 1 December 2022.
Eligibility criteria: The inclusion criteria involved studies that reported cognitive impairment in COPD. We just included cohort designs, published in English or Chinese language.
Data extraction and synthesis: Two reviewers independently extracted and assessed the quality of data using Newcastle-Ottawa Quality Assessment Scale. The outcomes were assessed with random-effects model and reported as the HR with 95% CI using the Review Manager software.
Results: 12 studies from 10 articles reporting on 625 644 people were included. The findings indicated that compared with those without COPD at baseline, patients with COPD were associated with an increased risk of cognitive impairment. Subgroup analysis showed the association was not significantly different in sex and age, and the subgroup supports that COPD has a higher risk of non-amnestic mild cognitive impairment (na-MCI) than amnestic MCI.
Conclusions: Patients with COPD have a higher risk of developing cognitive impairment and are more likely to cause na-MCI compared with those without COPD, and this risk is not affected by gender or age. Therefore, continuous monitoring of cognitive function in COPD is critical.
期刊介绍：
BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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