Prevalence and Risk Factors of Cognitive Impairment in COPD: A Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
ABSTRACT Aim The aim of this systematic review is to present the pooled estimated prevalence and risk factors for cognitive impairment (CI) in patients with chronic obstructive pulmonary disease (COPD). Background Patients with COPD suffer from progressive and irreversible airflow limitation, resulting in continuous impairment of lung function, which in addition to causing lesions in the lungs, often accrues to other organs as well. In recent years, a growing number of cross‐sectional and longitudinal studies have shown that hypoxia is an important factor in causing CI and that there is an important link between them, but the assessment of co‐morbid neurocognitive impairment and dysfunction is often overlooked. Some studies suggest that the diagnosis of mild cognitive impairment (MCI) is considered a precursor to dementia symptoms, with an annual conversion rate of 5%–10%, and it has been suggested that MCI is a potentially reversible state that can be used as a window for intervention. There is a lack of evidence on the prevalence and influencing factors of CI and its MCI. Design A systematic review and meta‐analysis. Methods PubMed, Web of Science, the Cochrane Library, Ovid, Wiley, and Scopus were searched for cohort, case‐control, and cross‐sectional studies investigating the prevalence and risk factors of CI and MCI in COPD to June 2023 from building. Meta‐analyses were performed to identify CI and MCI prevalence and risk factors using a random‐effects model. The methodological quality assessment was conducted by the modified Newcastle‐Ottawa Scale (NOS) and Agency for Healthcare Research and Quality (AHRQ). This study was registered on PROSPERO (CRD42021254124). Results In total, 41 studies (21 cohort studies, 7 case‐control studies, and 13 cross‐sectional studies) involving 138,030 participants were eligible for inclusion. Current evidence suggests that the average prevalence of CI and MCI in COPD was 20%–30% (95% CI, 0.17–0.28) and 24% (95% CI, 0.17–0.32), respectively. Significant heterogeneity existed both in CI and MCI ( I 2 = 99.76%, 91.40%, p < 0.001). Mata‐regression analysis showed that different region could be the source of heterogeneity in the pooled results. Cough, FEV1, PaO 2, age, education, depression, and BODE index are influential factors in the development of CI in COPD. Conclusion Integrated epidemiological evidence supports the hypothesis that the prevalence of CI in the COPD population has shown an increasing trend, with differences by region and by instrument. Cough, FEV1, PaO 2 , age, education, depression, and BODE index are influential factors in the development of cognitive impairment in COPD patients. We should promote early screening and management of COPD patients and take targeted measures to prevent and reduce the incidence of CI. Implications for Practice This systematic evaluation and meta‐analysis identifies seven important risk factors for the development of CI among COPD patients and exposes their current epidemiological findings to provide a theoretical basis for public health administrators and healthcare professionals to effectively increase the screening rate of cognitive impairment in patients with COPD as well as to carry out early intervention. Trial Registration PROSPERO).crd. york.ac.uk
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".