RT Journal Article
SR Electronic
T1 The presence of emphysema on chest imaging and mid-life cognition
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00048-2021
DO 10.1183/23120541.00048-2021
VO 7
IS 1
A1 Benjamin E. Henkle
A1 Laura A. Colangelo
A1 Mark T. Dransfield
A1 Lifang Hou
A1 David R. Jacobs, Jr
A1 Brian T. Joyce
A1 Carrie L. Pistenmaa
A1 Rachel K. Putman
A1 Steve Sidney
A1 Bharat Thyagarajan
A1 George R. Washko
A1 Kristine Yaffe
A1 Ravi Kalhan
A1 Ken M. Kunisaki
YR 2021
UL http://openres.ersjournals.com/content/7/1/00048-2021.abstract
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.Visual emphysema on thoracic CT imaging is associated with worse cognitive test performance. This association is independent of lung function and suggests that emphysema may be a novel risk factor for cognitive impairment. https://bit.ly/2LBTYaE