Cognitive performance is lower among individuals with overlap syndrome than in individuals with COPD or obstructive sleep apnea alone: association with carotid artery stiffness
Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are both independently associated with increased cardiovascular disease (CVD) risk and impaired cognitive function. It is unknown if individuals with both COPD and OSA (i.e., overlap syndrome) have greater common carotid...
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creator | Luehrs, Rachel E Moreau, Kerrie L Pierce, Gary L Wamboldt, Frederick Aloia, Mark Weinberger, Howard D Make, Barry Bowler, Russell Crapo, James D Meschede, Kimberly Kozora, Elizabeth Moser, David J Hoth, Karin F |
description | Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are both independently associated with increased cardiovascular disease (CVD) risk and impaired cognitive function. It is unknown if individuals with both COPD and OSA (i.e., overlap syndrome) have greater common carotid artery (CCA) stiffness, an independent predictor of CVD risk, and lower cognitive performance than either COPD or OSA alone. Elevated CCA stiffness is associated with cognitive impairment in former smokers with and without COPD in past studies. We compared CCA stiffness and cognitive performance between former smokers with overlap syndrome, COPD only, OSA only and former smoker controls using analysis of covariance (ANCOVA) tests to adjust for age, sex, body mass index (BMI), pack years, and postbronchodilator FEV
/FVC. We also examined the association between CCA stiffness and cognitive performance among each group separately. Individuals with overlap syndrome (
= 12) had greater CCA β-stiffness index (
= 0.015) and lower executive function-processing speed (
= 0.019) than individuals with COPD alone (
= 47), OSA alone (
= 9), and former smoker controls (
= 21), differences that remained significant after adjusting for age, BMI, sex, pack years, and FEV
/FVC. Higher CCA β-stiffness index was associated with lower executive function-processing speed in individuals with overlap syndrome (
= -0.58,
= 0.047). These data suggest that CCA stiffness is greater and cognitive performance is lower among individuals with overlap syndrome compared with individuals with COPD or OSA alone and that CCA stiffening may be an underlying mechanism contributing to the lower cognitive performance observed in patients with overlap syndrome.
Previous studies have demonstrated greater carotid artery stiffness and lower cognitive function among individuals with COPD alone and OSA alone. However, the present study is the first to demonstrate that individuals that have both COPD and OSA (i.e., overlap syndrome) have greater carotid artery stiffness and lower executive function-processing speed than individuals with either disorder alone. Furthermore, among individuals with overlap syndrome greater carotid artery stiffness is associated with lower executive function-processing speed. |
doi_str_mv | 10.1152/japplphysiol.00477.2020 |
format | Article |
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/FVC. We also examined the association between CCA stiffness and cognitive performance among each group separately. Individuals with overlap syndrome (
= 12) had greater CCA β-stiffness index (
= 0.015) and lower executive function-processing speed (
= 0.019) than individuals with COPD alone (
= 47), OSA alone (
= 9), and former smoker controls (
= 21), differences that remained significant after adjusting for age, BMI, sex, pack years, and FEV
/FVC. Higher CCA β-stiffness index was associated with lower executive function-processing speed in individuals with overlap syndrome (
= -0.58,
= 0.047). These data suggest that CCA stiffness is greater and cognitive performance is lower among individuals with overlap syndrome compared with individuals with COPD or OSA alone and that CCA stiffening may be an underlying mechanism contributing to the lower cognitive performance observed in patients with overlap syndrome.
Previous studies have demonstrated greater carotid artery stiffness and lower cognitive function among individuals with COPD alone and OSA alone. However, the present study is the first to demonstrate that individuals that have both COPD and OSA (i.e., overlap syndrome) have greater carotid artery stiffness and lower executive function-processing speed than individuals with either disorder alone. Furthermore, among individuals with overlap syndrome greater carotid artery stiffness is associated with lower executive function-processing speed.</description><identifier>ISSN: 8750-7587</identifier><identifier>EISSN: 1522-1601</identifier><identifier>DOI: 10.1152/japplphysiol.00477.2020</identifier><identifier>PMID: 33982592</identifier><language>eng</language><publisher>United States: American Physiological Society</publisher><subject>Apnea ; Body mass ; Body mass index ; Body size ; Cardiovascular diseases ; Carotid Arteries ; Carotid artery ; Carotid Artery, Common ; Chronic obstructive pulmonary disease ; Cognition ; Cognitive ability ; Executive function ; Health risks ; Heart diseases ; Humans ; Lung diseases ; Obstructive lung disease ; Processing speed ; Pulmonary artery ; Pulmonary Disease, Chronic Obstructive ; Sex ; Sleep ; Sleep apnea ; Sleep Apnea, Obstructive ; Sleep disorders ; Stiffening ; Stiffness</subject><ispartof>Journal of applied physiology (1985), 2021-07, Vol.131 (1), p.131-141</ispartof><rights>Copyright American Physiological Society Jul 2021</rights><rights>Published by the American Physiological Society 2021 American Physiological Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-828c81441b2d985b2c472fbd31c14fe6dfd7b1c9354b40a194f54a7fc9a1993e3</citedby><cites>FETCH-LOGICAL-c445t-828c81441b2d985b2c472fbd31c14fe6dfd7b1c9354b40a194f54a7fc9a1993e3</cites><orcidid>0000-0001-9298-047X ; 0000-0001-7499-080X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,3039,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33982592$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Luehrs, Rachel E</creatorcontrib><creatorcontrib>Moreau, Kerrie L</creatorcontrib><creatorcontrib>Pierce, Gary L</creatorcontrib><creatorcontrib>Wamboldt, Frederick</creatorcontrib><creatorcontrib>Aloia, Mark</creatorcontrib><creatorcontrib>Weinberger, Howard D</creatorcontrib><creatorcontrib>Make, Barry</creatorcontrib><creatorcontrib>Bowler, Russell</creatorcontrib><creatorcontrib>Crapo, James D</creatorcontrib><creatorcontrib>Meschede, Kimberly</creatorcontrib><creatorcontrib>Kozora, Elizabeth</creatorcontrib><creatorcontrib>Moser, David J</creatorcontrib><creatorcontrib>Hoth, Karin F</creatorcontrib><title>Cognitive performance is lower among individuals with overlap syndrome than in individuals with COPD or obstructive sleep apnea alone: association with carotid artery stiffness</title><title>Journal of applied physiology (1985)</title><addtitle>J Appl Physiol (1985)</addtitle><description>Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are both independently associated with increased cardiovascular disease (CVD) risk and impaired cognitive function. It is unknown if individuals with both COPD and OSA (i.e., overlap syndrome) have greater common carotid artery (CCA) stiffness, an independent predictor of CVD risk, and lower cognitive performance than either COPD or OSA alone. Elevated CCA stiffness is associated with cognitive impairment in former smokers with and without COPD in past studies. We compared CCA stiffness and cognitive performance between former smokers with overlap syndrome, COPD only, OSA only and former smoker controls using analysis of covariance (ANCOVA) tests to adjust for age, sex, body mass index (BMI), pack years, and postbronchodilator FEV
/FVC. We also examined the association between CCA stiffness and cognitive performance among each group separately. Individuals with overlap syndrome (
= 12) had greater CCA β-stiffness index (
= 0.015) and lower executive function-processing speed (
= 0.019) than individuals with COPD alone (
= 47), OSA alone (
= 9), and former smoker controls (
= 21), differences that remained significant after adjusting for age, BMI, sex, pack years, and FEV
/FVC. Higher CCA β-stiffness index was associated with lower executive function-processing speed in individuals with overlap syndrome (
= -0.58,
= 0.047). These data suggest that CCA stiffness is greater and cognitive performance is lower among individuals with overlap syndrome compared with individuals with COPD or OSA alone and that CCA stiffening may be an underlying mechanism contributing to the lower cognitive performance observed in patients with overlap syndrome.
Previous studies have demonstrated greater carotid artery stiffness and lower cognitive function among individuals with COPD alone and OSA alone. However, the present study is the first to demonstrate that individuals that have both COPD and OSA (i.e., overlap syndrome) have greater carotid artery stiffness and lower executive function-processing speed than individuals with either disorder alone. Furthermore, among individuals with overlap syndrome greater carotid artery stiffness is associated with lower executive function-processing speed.</description><subject>Apnea</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Cardiovascular diseases</subject><subject>Carotid Arteries</subject><subject>Carotid artery</subject><subject>Carotid Artery, Common</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Cognition</subject><subject>Cognitive ability</subject><subject>Executive function</subject><subject>Health risks</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Lung diseases</subject><subject>Obstructive lung disease</subject><subject>Processing speed</subject><subject>Pulmonary artery</subject><subject>Pulmonary Disease, Chronic Obstructive</subject><subject>Sex</subject><subject>Sleep</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive</subject><subject>Sleep disorders</subject><subject>Stiffening</subject><subject>Stiffness</subject><issn>8750-7587</issn><issn>1522-1601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplks1u1DAUhS0EokPhFcASGzYZbCeOHRZI1fArVSoLWFuOczPjkWMH25lq3opHxO2UqsDqWrrfOddHOgi9omRNKWdv93qe3bw7JhvcmpBGiDUjjDxCq7JlFW0JfYxWUnBSCS7FGXqW0p4Q2jScPkVndd1Jxju2Qr82YetttgfAM8QxxEl7A9gm7MI1RKyn4LfY-sEe7LBol_C1zTscDhCdnnE6-iGGCXDeaV-w_8nN1bcPOEQc-pTjYm4vJQcwYz170Fi74OEd1ikFY3W2wZ90RseQ7YB1zBCPOGU7jh5Seo6ejMUcXtzNc_Tj08fvmy_V5dXnr5uLy8qUjLmSTBpZ4tKeDZ3kPTONYGM_1NTQZoR2GAfRU9PVvOkbomnXjLzRYjRdeXc11Ofo_cl3XvoJBgM-R-3UHO2k41EFbdXfG293ahsOStaMt7QtBm_uDGL4uUDKarLJgHPaQ1iSYpy1NeEFL-jrf9B9WKIv8QrFhWxl04pCiRNlYkgpwnj_GUrUTSvUw1ao21aom1YU5cuHWe51f2pQ_wY8ir2H</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Luehrs, Rachel E</creator><creator>Moreau, Kerrie L</creator><creator>Pierce, Gary L</creator><creator>Wamboldt, Frederick</creator><creator>Aloia, Mark</creator><creator>Weinberger, Howard D</creator><creator>Make, Barry</creator><creator>Bowler, Russell</creator><creator>Crapo, James D</creator><creator>Meschede, Kimberly</creator><creator>Kozora, Elizabeth</creator><creator>Moser, David J</creator><creator>Hoth, Karin F</creator><general>American Physiological Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9298-047X</orcidid><orcidid>https://orcid.org/0000-0001-7499-080X</orcidid></search><sort><creationdate>20210701</creationdate><title>Cognitive performance is lower among individuals with overlap syndrome than in individuals with COPD or obstructive sleep apnea alone: association with carotid artery stiffness</title><author>Luehrs, Rachel E ; Moreau, Kerrie L ; Pierce, Gary L ; Wamboldt, Frederick ; Aloia, Mark ; Weinberger, Howard D ; Make, Barry ; Bowler, Russell ; Crapo, James D ; Meschede, Kimberly ; Kozora, Elizabeth ; Moser, David J ; Hoth, Karin F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-828c81441b2d985b2c472fbd31c14fe6dfd7b1c9354b40a194f54a7fc9a1993e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Apnea</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Cardiovascular diseases</topic><topic>Carotid Arteries</topic><topic>Carotid artery</topic><topic>Carotid Artery, Common</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Cognition</topic><topic>Cognitive ability</topic><topic>Executive function</topic><topic>Health risks</topic><topic>Heart diseases</topic><topic>Humans</topic><topic>Lung diseases</topic><topic>Obstructive lung disease</topic><topic>Processing speed</topic><topic>Pulmonary artery</topic><topic>Pulmonary Disease, Chronic Obstructive</topic><topic>Sex</topic><topic>Sleep</topic><topic>Sleep apnea</topic><topic>Sleep Apnea, Obstructive</topic><topic>Sleep disorders</topic><topic>Stiffening</topic><topic>Stiffness</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luehrs, Rachel E</creatorcontrib><creatorcontrib>Moreau, Kerrie L</creatorcontrib><creatorcontrib>Pierce, Gary L</creatorcontrib><creatorcontrib>Wamboldt, Frederick</creatorcontrib><creatorcontrib>Aloia, Mark</creatorcontrib><creatorcontrib>Weinberger, Howard D</creatorcontrib><creatorcontrib>Make, Barry</creatorcontrib><creatorcontrib>Bowler, Russell</creatorcontrib><creatorcontrib>Crapo, James D</creatorcontrib><creatorcontrib>Meschede, Kimberly</creatorcontrib><creatorcontrib>Kozora, Elizabeth</creatorcontrib><creatorcontrib>Moser, David J</creatorcontrib><creatorcontrib>Hoth, Karin F</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of applied physiology (1985)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luehrs, Rachel E</au><au>Moreau, Kerrie L</au><au>Pierce, Gary L</au><au>Wamboldt, Frederick</au><au>Aloia, Mark</au><au>Weinberger, Howard D</au><au>Make, Barry</au><au>Bowler, Russell</au><au>Crapo, James D</au><au>Meschede, Kimberly</au><au>Kozora, Elizabeth</au><au>Moser, David J</au><au>Hoth, Karin F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cognitive performance is lower among individuals with overlap syndrome than in individuals with COPD or obstructive sleep apnea alone: association with carotid artery stiffness</atitle><jtitle>Journal of applied physiology (1985)</jtitle><addtitle>J Appl Physiol (1985)</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>131</volume><issue>1</issue><spage>131</spage><epage>141</epage><pages>131-141</pages><issn>8750-7587</issn><eissn>1522-1601</eissn><abstract>Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are both independently associated with increased cardiovascular disease (CVD) risk and impaired cognitive function. It is unknown if individuals with both COPD and OSA (i.e., overlap syndrome) have greater common carotid artery (CCA) stiffness, an independent predictor of CVD risk, and lower cognitive performance than either COPD or OSA alone. Elevated CCA stiffness is associated with cognitive impairment in former smokers with and without COPD in past studies. We compared CCA stiffness and cognitive performance between former smokers with overlap syndrome, COPD only, OSA only and former smoker controls using analysis of covariance (ANCOVA) tests to adjust for age, sex, body mass index (BMI), pack years, and postbronchodilator FEV
/FVC. We also examined the association between CCA stiffness and cognitive performance among each group separately. Individuals with overlap syndrome (
= 12) had greater CCA β-stiffness index (
= 0.015) and lower executive function-processing speed (
= 0.019) than individuals with COPD alone (
= 47), OSA alone (
= 9), and former smoker controls (
= 21), differences that remained significant after adjusting for age, BMI, sex, pack years, and FEV
/FVC. Higher CCA β-stiffness index was associated with lower executive function-processing speed in individuals with overlap syndrome (
= -0.58,
= 0.047). These data suggest that CCA stiffness is greater and cognitive performance is lower among individuals with overlap syndrome compared with individuals with COPD or OSA alone and that CCA stiffening may be an underlying mechanism contributing to the lower cognitive performance observed in patients with overlap syndrome.
Previous studies have demonstrated greater carotid artery stiffness and lower cognitive function among individuals with COPD alone and OSA alone. However, the present study is the first to demonstrate that individuals that have both COPD and OSA (i.e., overlap syndrome) have greater carotid artery stiffness and lower executive function-processing speed than individuals with either disorder alone. Furthermore, among individuals with overlap syndrome greater carotid artery stiffness is associated with lower executive function-processing speed.</abstract><cop>United States</cop><pub>American Physiological Society</pub><pmid>33982592</pmid><doi>10.1152/japplphysiol.00477.2020</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9298-047X</orcidid><orcidid>https://orcid.org/0000-0001-7499-080X</orcidid><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; American Physiological Society; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
subjects | Apnea Body mass Body mass index Body size Cardiovascular diseases Carotid Arteries Carotid artery Carotid Artery, Common Chronic obstructive pulmonary disease Cognition Cognitive ability Executive function Health risks Heart diseases Humans Lung diseases Obstructive lung disease Processing speed Pulmonary artery Pulmonary Disease, Chronic Obstructive Sex Sleep Sleep apnea Sleep Apnea, Obstructive Sleep disorders Stiffening Stiffness |
title | Cognitive performance is lower among individuals with overlap syndrome than in individuals with COPD or obstructive sleep apnea alone: association with carotid artery stiffness |
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