Abstract
BackgroundCognitive and motor-performance decline with age and the process is accelerated by decline in general health. In this study, we aimed to estimate the effects of COPD and HB levels on cognitive and motor performance in the general older population and assess potential interaction.MethodsThe English Longitudinal Study of Aging is a population-based cohort study including measurements of lung-function and HB levels together with cognitive and motor performance testing. Data were collected from 5709 participants including three measurement time over eight years. COPD was defined using lung-function-parameters and clinical symptoms. HB was assessed continuously and low HB was defined using clinical anemia cutoffs. Linear mixed-effects regression models were used to quantify the associations of COPD and HB with outcome measures, both individually and in combination.ResultsParticipants with both low HB and COPD demonstrated worse motor performance compared to individuals with only one exposure, resulting in up to 1 s (95%CI, 0.04–1.8) longer time needed to complete the five times sit to stand task than what would be expected based on purely additive effects. Additionally in individuals with COPD, the time to complete the motor-performance task per unit decrease in continuous HB levels was longer than in participants without COPD after full adjustment for confounding (up to 1.38 s/unit HB level, 95% CI: 0.65–2.11).ConclusionIn persons with COPD low HB levels may contribute to low motor-performance in a supra additive fashion. Further studies should re-evaluate whether earlier treatment of lower HB in these individuals might be beneficial.
Highlights
Cognitive and motor-performance decline with age and the process is accelerated by decline in general health
The final dataset used in model model 1 (M1) included 8351 measurements collected over the three waves from 5709 participants (Fig. 1)
In our study, we found that both Chronic Obstructive Pulmonary Disease (COPD) presence and severity and low HB levels were associated with motor performance in the older general population
Summary
Cognitive and motor-performance decline with age and the process is accelerated by decline in general health. We aimed to estimate the effects of COPD and HB levels on cognitive and motor performance in the general older population and assess potential interaction. With increasing age, both cognitive and motorperformance begin to slowly decline [1, 2]. Partly associated with chronic inflammation, low HB levels have been reported to occur more frequently among persons with COPD with a prevalence between 10 and 30% in COPD patients and approximately 6% in the general older population [11, 12, 15, 16]. HB levels have been reported to increase by an erythropoietin mediated mechanism that to some degree compensates for the oxygen deprivation characteristic of chronic diseases such as COPD [6]
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