Impact of COPD and anemia on motor and cognitive performance in the general older population: results from the English longitudinal study of ageing

Abstract

Background: Cognitive and motor-performance decline with age and the process is accelerated by decline in general health. In this study, we aimed to estimate the effects of COPD and HB levels on cognitive and motor performance in the general older population and assess potential interaction. Methods: The English Longitudinal Study of Aging is a population-based cohort study including measurements of lung-function and HB levels together with cognitive and motor performance testing. Data were collected from 5709 participants including three measurement time over eight years. COPD was defined using lung-functionparameters and clinical symptoms. HB was assessed continuously and low HB was defined using clinical anemia cutoffs. Linear mixed-effects regression models were used to quantify the associations of COPD and HB with outcome measures, both individually and in combination. Results: Participants with both low HB and COPD demonstrated worse motor performance compared to individuals with only one exposure, resulting in up to 1 s (95%CI, 0.04-1.8) longer time needed to complete the five times sit to stand task than what would be expected based on purely additive effects. Additionally in individuals with COPD, the time to complete the motor-performance task per unit decrease in continuous HB levels was longer than in participants without COPD after full adjustment for confounding (up to 1.38 s/unit HB level, 95% CI: 0.65-2.11). Conclusion: In persons with COPD low HB levels may contribute to low motor-performance in a supra additive fashion. Further studies should re-evaluate whether earlier treatment of lower HB in these individuals might be beneficial.

Treatable traits in an English cohort: prevalence and predictors of future decline in lung function and quality of life in COPD

“…For the purposes of this analysis, individuals who had a fixed ratio of FEV 1 /FVC <0.70 (spirometry data were not post-bronchodilator) and relevant symptoms (phlegm, dyspnoea and wheezing), but did not self-report a diagnosis of asthma, were regarded as having COPD [ 12 ]. The severity of COPD was determined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification system [ 13 ] and was categorised into “healthy/non-COPD” (FEV 1 /FVC ≥0.7), “mild” (FEV 1 /FVC <0.7 and FEV 1 ≥80%pred), “moderate” (FEV 1 /FVC <0.7 and 50% ≤FEV 1 <80%pred), “severe” (FEV 1 /FVC <0.7 and 30% ≤FEV 1 <50%pred) or “very severe” (FEV 1 /FVC <0.7 and FEV 1 <30%pred).…”

Cerebral Hypoxia: Its Role in Age-Related Chronic and Acute Cognitive Dysfunction

“…Acute anemia elicits cognitive impairment even in healthy individuals. 47 Anemia that accompanies HF, 48 COPD, 49 and lung cancer 50 has been associated with cognitive impairment, although the rate of anemia in chronic kidney disease may not contribute to cognitive decline. 51 Chronic anemia has been associated with impaired cognitive performance, even in otherwise healthy adolescents 52 and adults.…”

Influence of SERPINA1 Gene Polymorphisms on Anemia and Chronic Obstructive Pulmonary Disease

“…The deficiency of iron subsequently leads to anemic conditions. The individuals who were diagnosed with COPD and lower hemoglobin content simultaneously showed poor motor performance [ 19 ]. Since the interrelationship between SERPINA1 and anemia has neither been studied nor been well-established, the novelty of the current findings is significant.…”