Fax +41 61 306 12 34
E-Mail karger@karger.ch
www.karger.com
Original Research Article
Dement Geriatr Cogn Disord 2006;21:300–308
DOI: 10.1159/000091438
Pulmonary Function, Cognitive
Impairment and Brain Atrophy in a
Middle-Aged Community Sample
P.S. Sachdev
a, b
K.J. Anstey
c
R.A. Parslow
c
W. Wen
a, b
J. Maller
c
R. Kumar
c
H. Christensen
c
A.F. Jorm
c
a
School of Psychiatry, University of New South Wales,
b
Neuropsychiatric Institute, the Prince of Wales Hospital,
Sydney,
c
Centre for Mental Health Research, Australian National University, Canberra, Australia
VBR but no other structural brain measure. Pulmonary
function was also significantly related to information
processing speed and fine motor dexterity. Male sub-
jects with chronic respiratory disease had more deep
WMHs. Path analyses to examine if structural measures
mediated between lung function and cognition, and
whether markers of inflammation and oxidative stress
or cortisol mediated between lung function and brain
measures were negative. Conclusions: Decreased lung
function is related to poorer cognitive function and in-
creased subcortical atrophy in mid-adult life. Presence
of chronic respiratory disease may be related to deep
WMHs in men.
Copyright © 2006 S. Karger AG, Basel
Introduction
There are many reasons why pulmonary function of
individuals may be related to their brain function. Lower
pulmonary function is often associated with diseases that
may also affect the brain. Chronic inflammation or infec-
tion of the lungs has been associated with an increased
risk of atherosclerosis [1]. Breathing disorders during
sleep have been related to cognitive dysfunction [2] . Lung
function is affected by lifestyle factors, in particular smok-
ing and physical activity, which have also been linked to
Key Words
Cognitive impairment Pulmonary function Brain
atrophy
Abstract
Objective: To determine the relationship of lung function
to brain anatomical parameters and cognitive function
and to examine the mediating factors for any relation-
ships. Methods: A random sub-sample of 469 persons
(men = 252) aged 60–64 years from a larger community
sample underwent brain magnetic resonance imaging
scans and pulmonary function tests (forced vital capac-
ity, FVC, forced expiratory volume in the first second,
FEV
1
). Subjects were assessed for global cognitive func-
tion, episodic memory, working memory, information
processing speed, fine motor dexterity and grip strength.
The magnetic resonance imaging scans were analysed
for overall brain atrophy, subcortical atrophy (ventricle-
to-brain ratio, VBR), hippocampal volume, and white
matter hyperintensity (WMH) volume. Results: FEV
1
had
a significant negative correlation with overall brain atro-
phy and VBR in men. The FEV
1
/FVC ratio had a significant
correlation with WMHs in both men and women. In re-
gression models that controlled for sex, age, height, lev-
el of activity, smoking, chronic respiratory disease and
education, FEV
1
and FVC were significant predictors of
Accepted after revision: July 24, 2005
Published online: February 10, 2006
Prof. P. Sachdev
NPI, Prince of Wales Hospital
Barker Street
Randwick NSW 2031 (Australia)
Tel. +61 2 9382 3763, Fax +61 2 9382 3774, E-Mail p.sachdev@unsw.edu.au
© 2006 S. Karger AG, Basel
1420–8008/06/0216–0300$23.50/0
Accessible online at:
www.karger.com/dem
Downloaded by:
Monash University
130.194.125.25 - 10/15/2014 1:40:00 AM