Effect of Coexisting COPD and Cognitive Impairment on Health Outcomes in Older Adults

Chronic obstructive pulmonary disease (COPD) relates to one of the most common lung diseases, which have the inherent ability to make breathing difficult. It is imperative to understand that there exist three main forms of chronic obstructive pulmonary disease including emphysema, chronic obstructive and chronic bronchitis. Individuals who have contracted COPD normally finds it very hard to breathe mainly due to narrowing of airways of the lung. It is essential that the most potent symptoms of COPD includes increased breathlessness, frequent chest pains and infections, and mostly persistent coughing accompanied with phlegm.

Main aim of the article in review is to establish the extent by which the co-occurrence of COPD coupled with cognitive impairment may influence fundamental health outcomes amongst older adults. The study conducted by Chang et al., 2012, aim at determining the aforementioned effects of COPD amongst older adults by employing use of design multicenter longitudinal cohort research. Chang et al., 2012 conducts the study within the neighborhoods of North Carolina, Pennsylvania, California, and Maryland.

It important to comprehend the extent by which coexisting cognitive impairment and COPD relate in contributing to fundamental clinical outcomes amongst older adults. Understanding the coexistence assists in ensuring that there would be a formidable health possibility of focusing on treatment priorities. In addition, understanding the coexistence between cognitive impairment and COPD would be imperative in establishing disease risks and obtaining of informed decisions that would be essential in fostering enhanced methods for disease management. Therefore, comprehensive information on the clinical influence of mainly coexisting chronic diseases remains authoritative in comprehending disease-associated burden. Besides, the knowledge acquired from the study is vital for clinicians who aim at using appropriate clinical care methods amongst older adults.

Cognitive impairment and COPD remains part of the most complicated chronic conditions that may mostly heighten with aging. The two chronic diseases normally have a close association with mortality and substantial morbidity amongst older adults. Studies suggest that possibility exist of a potential positive coexistence and interrelation between cognitive impairment and COPD. Other similar studies have suggested that there exists an association between the two aforementioned chronic conditions with high rates of death and hospitalization amongst older adults.  Therefore, the study conducted by Chang et al., 2012, aimed at establishing the suggested coexistence or interrelations between COPD and cognitive impairment (Chang et al., 2012).

The participants of the study that Chang et al., 2012 recruited included adults aged between 65 and 85 years. The study recruited approximately 93 community-dwelling adults who have not participated in any cardiovascular health study. From the baseline of the study, Chang et al., 2012 found approximately 431 participants who suffered from chronic obstructive pulmonary disease. It is imperative that the study included a measurement follow-up that proceed for the next three years mainly at the CHS visit.

Chang et al., 2012, employed use of Spirometric criteria designed for airflow limitation in establishing the existence of COPD after employing the method of Lambda- Mu- Sigma (LMS). Lambda- Mu- Sigma method was indispensable in accounting for the inherent age-related changes with respect to lung function.  Thereafter, Chang et al., 2012, conducted cognitive impairment evaluation by employing use of data obtained from mini-mental state examinations. The fundamental results of the aforementioned tests included all-cause hospitalization, death and respiratory related issues.

The inherent results obtained from the test indicated that research subjects with cognitive impairment and coexisting COPD recorded the largest rates of related respiratory issues as well as all-cause hospitalization, and death. In addition, it is essential to note that the results indicated that all participants who showed signs of both of the aforementioned conditions had 48 percent higher rates of all-cause hospitalizations. Moreover, in such cases where participants show signs of both conditions, there also exist nearly three times higher rate of death compared to the total sum of risks recorded. The sum of risks may remain recorded for every respective outcome that directly remains in association with only cognitive impairment or COPD.

It is essential to understand that the abovementioned tests especially those that involved interactions with participants had no statistical significance in relation to presence of synergism. The lack of significance in statistics for the presence of synergism within the results obtained from interactions study remained the most fundamental for understanding the two chronic conditions that contributed to all of the above-mentioned health outcomes. Chang et al., 2012 suggests that there cannot be a formidable conclusion that combination of effects on respiratory related issues with all-cause hospitalizations or death may remain greater than when additive.

Chang et al., 2012 concludes that a coexistence between cognitive impairment and COPD would have an additive impact mostly on all-cause hospitalizations, death, and respiratory-related problems. According to Chang et al., 2012, there would be greater need for determination of how to improve concurrent management mainly for realization of optimized cognitive impairment and COPD.

The most plausible explanation to the aforementioned results established by Chang et al., 2012 remains that there exists a diminishing effect on the coexistence COPD and cognitive impairment mainly on the outcomes. The diminishing effects may result from other influential complicated chronic conditions, advancing age, and baseline functional limitations.  Other rationale for the obtained results from the study may be biasness in the population used in research. It is important to establish that the population employed by Chang et al., 2012 in their research mainly consisted of the Whites in the range of years between 65 and 80. Therefore, the results may not have remained reflective of the whole population due to lack of a designed ethnic minority LMS method. Moreover, the LMS method employed in the study may have decreased detection of synergistic effects due to its inability to use large sample sizes.  It is vital to understand that restricting sample size within an LMS method directly contributes to reduction in ability to detect synergistic effects between the Coexisting COPD and the inherent cognitive impairment.

Irrespective of the potential limitations of the study that may have arisen as above mentioned, Chang et al., 2012, research remains imperative for clinicians who aim at understanding the interrelationship between COPD and cognitive impairment. In addition, the study remains essential in providing a viable blueprint for concurrent research on the hypothetical health question relating to the two chronic conditions amongst older adults.


Chang, S. S., Chen, S., McAvay, G. J., & Tinetti, M. E. (2012). Effect of Coexisting Chronic Obstructive Pulmonary Disease and Cognitive Impairment on Health Outcomes in Older Adults. Journal Of The American Geriatrics Society, 60(10), 1839-1846. doi:10.1111/j.1532-5415.2012.04171.x

Let's make that grade!