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Forced expiratory volume in 1 second and cognitive aging in men.

ABSTRACT: To evaluate forced expiratory volume in 1 second (FEV(1) , a measure of overall lung function), long-term average FEV(1) , and rate of decline in FEV(1) in relation to cognition and cognitive decline in older men.Prospective observational study.Community-based population.Eight hundred sixty-four older men from the Normative Aging Study.Starting in 1984, participants underwent triennial clinical evaluations. Lung function assessments provided estimates of FEV(1) . Cognitive assessments entailing tests of several cognitive abilities began in 1993. FEV(1) measured approximately 12 years before baseline cognitive testing, average FEV(1) over the 12-year period, and rate of change in FEV(1) were all evaluated in relation to baseline and change in performance on the cognitive tests.In multivariable-adjusted analyses, associations between FEV(1) and baseline cognitive scores were mixed, although average FEV(1) predicted significantly better performance on tests of visuospatial ability (P=.04) and general cognition (P=.03). Higher FEV(1) was more consistently associated with slower cognitive decline, but only the association between historical FEV(1) and attention was significant (difference per standard deviation in FEV(1) =0.056, P=.05). Rate of FEV(1) decline was not consistently associated with cognitive function or decline. Findings were generally similar or stronger in men who had never smoked. To account for potential bias due to selective attrition, inverse probability of censoring weights were applied to the cognitive decline analyses, yielding slightly larger estimates; the inadequate prognostic power of the censoring models limited this approach.Overall, the data provide limited evidence of an inverse association between FEV(1) and cognitive aging.

SUBMITTER: Weuve J

PROVIDER: S-EPMC3758858 | biostudies-literature | 2011 Jul

REPOSITORIES: biostudies-literature

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Forced expiratory volume in 1 second and cognitive aging in men.

Weuve Jennifer J Glymour M Maria MM Hu Howard H Sparrow David D Spiro Avron A Vokonas Pantel S PS Litonjua Augusto A AA

Journal of the American Geriatrics Society 20110630 7

<h4>Objectives</h4>To evaluate forced expiratory volume in 1 second (FEV(1) , a measure of overall lung function), long-term average FEV(1) , and rate of decline in FEV(1) in relation to cognition and cognitive decline in older men.<h4>Design</h4>Prospective observational study.<h4>Setting</h4>Community-based population.<h4>Participants</h4>Eight hundred sixty-four older men from the Normative Aging Study.<h4>Measurements</h4>Starting in 1984, participants underwent triennial clinical evaluation ...[more]

PMID: 21718272

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Project description:Rationale: The American Thoracic Society (ATS)/European Respiratory Society defines a positive bronchodilator response (BDR) by a composite of BDR in either forced expiratory volume in 1 second (FEV1) and/or forced vital capacity (FVC) greater than or equal to 12% and 200 ml (ATS-BDR). We hypothesized that ATS-BDR components would be differentially associated with important chronic obstructive pulmonary disease (COPD) outcomes. Objectives: To examine whether ATS-BDR components are differentially associated with clinical, functional, and radiographic features in COPD. Methods: We included subjects with COPD enrolled in the COPDGene study. In the main analysis, we excluded subjects with self-reported asthma. We categorized BDR into the following: 1) No-BDR, no BDR in either FEV1 or FVC; 2) FEV1-BDR, BDR in FEV1 but no BDR in FVC; 3) FVC-BDR, BDR in FVC but no BDR in FEV1; and 4) Combined-BDR, BDR in both FEV1 and FVC. We constructed multivariable logistic, linear, zero-inflated negative binomial, and Cox hazards models to examine the association of BDR categories with symptoms, computed tomography findings, change in FEV1 over time, respiratory exacerbations, and mortality. We also created models using the ATS BDR definition (ATS-BDR) as the main independent variable. Results: Of 3,340 COPD subjects included in the analysis, 1,083 (32.43%) had ATS-BDR, 182 (5.45%) had FEV1-BDR, 522 (15.63%) had FVC-BDR, and 379 (11.34%) had Combined-BDR. All BDR categories were associated with FEV1 decline compared with No-BDR. Compared with No-BDR, both ATS-BDR and Combined-BDR were associated with higher functional residual capacity %predicted, greater internal perimeter of 10 mm, and greater 6-minute-walk distance. In contrast to ATS-BDR, Combined-BDR was independently associated with less emphysema (adjusted beta regression coefficient, -1.67; 95% confidence interval [CI], -2.68 to -0.65; P = 0.001), more frequent respiratory exacerbations (incidence rate ratio, 1.25; 95% CI, 1.03-1.50; P = 0.02) and severe exacerbations (incidence rate ratio, 1.34; 95% CI, 1.05-1.71; P = 0.02), and lower mortality (adjusted hazards ratio, 0.76; 95% CI, 0.58-0.99; P = 0.046). Sensitivity analysis that included subjects with self-reported history of asthma showed similar findings. Conclusions: BDR in both FEV1 and FVC indicates a COPD phenotype with asthma-like characteristics, and provides clinically more meaningful information than current definitions of BDR.

Dataset Information

Forced expiratory volume in 1 second and cognitive aging in men.

Publications

Forced expiratory volume in 1 second and cognitive aging in men.

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