Chronic Respiratory Diseases and Neurodegenerative Disorders: A Primer for the Practicing Clinician

Abstract

Chronic respiratory disorders represent a world epidemic. Their incidence and prevalence in the world population is increasing, and especially among elderly subjects, they are commonly associated with other pathologies, often generating a status of high clinical complexity. Neurology, internal medicine, and pneumology specialists should be aware of the common background of these disorders in order to treat correctly the patient’s comorbid state and optimize the treatment considering potential overlaps. In this review, we aimed to focus on the relationships between chronic respiratory disorders and chronic neurodegenerative diseases at different levels; we review the shared risk factors and the interactions between disorders, the indications to explore respiratory function in neurodegenerative diseases, pathology-pathology and drug-pathology interactions in patients affected by both chronic neurologic and respiratory diseases.

A systematic review and meta‐analysis of respiratory dysfunction in Parkinson's disease

“…Meta‐analyses of spirometry data demonstrate a pattern more suggestive of a restrictive respiratory disorder, as reported in the literature, 91 than obstructive. This is supported by low heterogeneity and a significantly reduced FVC and FEV1 in the ON phase, a normal FEV1/FVC 92, 93 and DLCO within normal ranges (>75% predicted) 94 in people with PD.…”

“…On balance, results point toward a strong pattern of restrictive dysfunction potentially caused by the inspiratory muscle weakness. Inspiratory muscle strength plays an important role in TV 104,111 and VC, 112 both of which were reduced, and weakness can cause decreased TLC and FRC, while FEV1/FVC and RV remain relatively normal once expiratory muscles are not weak 91 as also identified in this review. Reduced MIP is a known predictor of diaphragm muscle weakness well before evidence of change in VC 104 or FVC.…”

Shared Molecular Mechanisms among Alzheimer’s Disease, Neurovascular Unit Dysfunction and Vascular Risk Factors: A Narrative Review

“…There is a narrow link between neurodegenerative diseases, as AD, and chronic lung pathologies, as COPD [ 138 ]. Chronic brain hypoxia, which is commonly observed in advanced COPD and worsened by the occurrence of significant carotid atherosclerosis, seems to worsen cognition by increasing Aβ deposition and tau hyperphosphorylation [ 139 , 140 ].…”

Letter on the Published Article “Chronic Respiratory Diseases and Neurodegenerative Disorders: A Primer for the Practicing Clinician”

“…Dear Editor, I read with great interest the article titled "Chronic Respiratory Diseases and Neurodegenerative Disorders: A Primer for the Practicing Clinician" by Falsetti et al [1]. The authors reviewed the relationship between chronic respiratory disorders and chronic neurodegenerative diseases with special reference to risk factors and interactions of these two disorders.…”