Chronic Obstructive Pulmonary Disease and Risk of Dementia and Mortality in Lower to Middle Income Countries
Date
2019
Authors
Cherbuin, Nicolas
Walsh, Erin
Prina, A. Matthew
Journal Title
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Volume Title
Publisher
IOS Press
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a major disease burden which accounts for 5% of all deaths
globally, with most of those (>90%) occurring in lower to middle income countries (LMIC). It is also emerging as an important
modifiable dementia risk factor.
Objective: To address the knowledge gap surrounding the nature of the associations between COPD, dementia, and mortality,
and the geographical variation of those associations in LMIC.
Methods: Data from the 10/66 study surveying 15,394 participants (mean age 74 years, 62% female) across 8 countries
was used to estimate the prevalence of self-reported COPD and its association with incident dementia and premature death.
Proportional sub-hazards models using a cumulative incidence function were applied to identify the probability of incident
dementia onset given the risk of premature death, with estimates pooled across countries via random effect meta-analysis.
Results: Over the 3-year follow-up, almost 10% of participants developed dementia and 14% were deceased. COPD was not
significantly associated with dementia incidence except in Cuba. However, fully adjusted models indicated that individuals
with COPD were at a 28% increased risk of premature death, a trend present across most countries when analyzed individually.
Conclusion: The link between COPD and dementia is currently somewhat different and weaker in LMIC than in developed
countries. This may be because premature death in the populations studied mask the development of clinical dementia. Given
the global trend toward increased life expectancy, it is critical that the disease burden associated with COPD be addressed
without delay if a further rise in dementia prevalence associated with COPD is to be avoided in LMIC.
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Source
Journal of Alzheimer’s Disease
Type
Journal article
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Access Statement
Open Access
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Creative Commons Attribution Non-Commercial License