Abstract：
BACKGROUND: The number of older people with cognitive impairment is increasing worldwide. Impaired lung function might be associated with cognitive decline in older age; however, results from large longitudinal studies are lacking. In this study, we examined the longitudinal associations between pulmonary function and the trajectories of cognitive decline using prospective population-based SHARE data from 14 countries.
METHODS: The analytic sample included N = 32,049 older adults (Mean age at baseline = 64.76 years). The dependent variable was cognitive performance, measured repeatedly across six waves in three domains: verbal fluency, memory, and numeracy. The main predictor of interest was peak expiratory flow (PEF). The data were analyzed in a multilevel accelerated longitudinal design, with models adjusted for a variety of covariates.
RESULTS: A lower PEF score was associated with lower cognitive performance for each domain as well as a lower global cognitive score. These associations remained statistically significant after adjusting for all covariates Q4 vs Q1 verbal fluency: unstandardized coefficient B = -3.15; numeracy: B = -0.52; memory: B = -0.64; global cognitive score B = -2.65, all p < .001). However, the PEF score was not found to be associated with the rate of decline for either of the cognitive outcomes.
CONCLUSIONS: In this large multi-national longitudinal study, the PEF score was independently associated with lower levels of cognitive functions, but it did not predict a future decline. The results suggest that pre-existing differences in lung functions are responsible for variability in cognitive functions and that these differences remained stable across aging.
METHODS: The analytic sample included N = 32,049 older adults (Mean age at baseline = 64.76 years). The dependent variable was cognitive performance, measured repeatedly across six waves in three domains: verbal fluency, memory, and numeracy. The main predictor of interest was peak expiratory flow (PEF). The data were analyzed in a multilevel accelerated longitudinal design, with models adjusted for a variety of covariates.
RESULTS: A lower PEF score was associated with lower cognitive performance for each domain as well as a lower global cognitive score. These associations remained statistically significant after adjusting for all covariates Q4 vs Q1 verbal fluency: unstandardized coefficient B = -3.15; numeracy: B = -0.52; memory: B = -0.64; global cognitive score B = -2.65, all p < .001). However, the PEF score was not found to be associated with the rate of decline for either of the cognitive outcomes.
CONCLUSIONS: In this large multi-national longitudinal study, the PEF score was independently associated with lower levels of cognitive functions, but it did not predict a future decline. The results suggest that pre-existing differences in lung functions are responsible for variability in cognitive functions and that these differences remained stable across aging.
摘要：
背景：在全球范围内，患有认知障碍的老年人数量正在增加。肺功能受损可能与老年人认知功能下降有关；然而，缺乏大型纵向研究的结果。在这项研究中,我们使用来自14个国家的前瞻性基于人群的SHARE数据,研究了肺功能与认知功能减退轨迹之间的纵向关联.
方法：分析样本包括N=32,049名老年人（基线时的平均年龄=64.76岁）。因变量是认知表现，在三个领域的六个波重复测量:言语流利，记忆,和算术。感兴趣的主要预测因子是峰值呼气流量(PEF)。数据在多级加速纵向设计中进行了分析，模型针对各种协变量进行了调整。
结果：较低的PEF评分与每个领域较低的认知表现以及较低的整体认知评分相关。在调整所有协变量Q4与Q1语言流畅性后，这些关联仍然具有统计学意义：未标准化系数B=-3.15;算术：B=-0.52;记忆：B=-0.64;全球认知得分B=-2.65，所有p<.001）。然而,未发现PEF评分与任一认知结局的下降率相关.
结论：在这项大型跨国纵向研究中，PEF评分与较低水平的认知功能独立相关，但它并没有预测未来的下降。结果表明，肺功能的预先存在的差异是认知功能变异性的原因，并且这些差异在整个衰老过程中保持稳定。
方法：分析样本包括N=32,049名老年人（基线时的平均年龄=64.76岁）。因变量是认知表现，在三个领域的六个波重复测量:言语流利，记忆,和算术。感兴趣的主要预测因子是峰值呼气流量(PEF)。数据在多级加速纵向设计中进行了分析，模型针对各种协变量进行了调整。
结果：较低的PEF评分与每个领域较低的认知表现以及较低的整体认知评分相关。在调整所有协变量Q4与Q1语言流畅性后，这些关联仍然具有统计学意义：未标准化系数B=-3.15;算术：B=-0.52;记忆：B=-0.64;全球认知得分B=-2.65，所有p<.001）。然而,未发现PEF评分与任一认知结局的下降率相关.
结论：在这项大型跨国纵向研究中，PEF评分与较低水平的认知功能独立相关，但它并没有预测未来的下降。结果表明，肺功能的预先存在的差异是认知功能变异性的原因，并且这些差异在整个衰老过程中保持稳定。
