Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study
Objectives This study aimed to investigate the relationship between disability and domain-specific cognitive function in older adults with chronic obstructive pulmonary disease (COPD).Design Cross-sectional analyses combined with retrospective longitudinal analyses.Setting We included 450 communitie...
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BMJ Publishing Group
2020-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/10/e040098.full |
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| author | Chao Wu Bingyan Gong Shaomei Shang |
| author_facet | Chao Wu Bingyan Gong Shaomei Shang |
| author_sort | Chao Wu |
| collection | DOAJ |
| description | Objectives This study aimed to investigate the relationship between disability and domain-specific cognitive function in older adults with chronic obstructive pulmonary disease (COPD).Design Cross-sectional analyses combined with retrospective longitudinal analyses.Setting We included 450 communities in China.Participants In this study, 1022 (mean age: 68.6±6.3; 612 males) and 152 (mean age: 67.0±5.2; 83 males) older adults with COPD from the China Health and Retirement Longitudinal Study were included in a cross-sectional multivariate linear regression analysis and a longitudinal logistic regression analysis, respectively.Outcome measures Disability was determined by the difficulty or inability to complete 1 of the 12 activity items in basic activities of daily living (ADL) and instrumental ADL. The cognitive dimensions of episodic memory, attention/numerical ability, orientation to time, and visuospatial ability were assessed via the immediate/delayed recall task, serial sevens task, naming the current date and pentagon-figure-drawing tasks, respectively.Results Of 1022 older respondents with COPD at wave-4, 48.5% had ADL disability. Declines in the global cognitive function (β (95% CI)=−0.627 (−1.214 to –0.040)), orientation to time (β (95% CI)=−0.207 (−0.364 to –0.050)) and visuospatial ability (β (95% CI)=−0.068 (−0.127 to –0.009)) were significantly associated with the presence of ADL disability, when demographic and health-related variables were adjusted. Of 152 older participants with COPD and without ADL disability in wave-2, 61 (40.1 %) developed disability over a 2-year follow-up. Relative to the participants without a decline in orientation to tine, those with the condition had greater odds of incidence of ADL disability increased by a factor of about 1.46 over a 2-year follow-up.Conclusions In older adults with COPD, orientation to time and visuospatial inability are vulnerable to the presence of a disability. Prevention of a decline in orientation to time might help prevent disability in older people with COPD. |
| format | Article |
| id | doaj-art-df3ec17fcac34436a40be92f8decdae6 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-df3ec17fcac34436a40be92f8decdae62024-11-16T17:55:08ZengBMJ Publishing GroupBMJ Open2044-60552020-10-01101010.1136/bmjopen-2020-040098Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal studyChao Wu0Bingyan Gong1Shaomei Shang21 Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, ChinaSchool of Nursing, Peking University, Beijing, ChinaPeking University School of Nursing, Peking University, Beijing, ChinaObjectives This study aimed to investigate the relationship between disability and domain-specific cognitive function in older adults with chronic obstructive pulmonary disease (COPD).Design Cross-sectional analyses combined with retrospective longitudinal analyses.Setting We included 450 communities in China.Participants In this study, 1022 (mean age: 68.6±6.3; 612 males) and 152 (mean age: 67.0±5.2; 83 males) older adults with COPD from the China Health and Retirement Longitudinal Study were included in a cross-sectional multivariate linear regression analysis and a longitudinal logistic regression analysis, respectively.Outcome measures Disability was determined by the difficulty or inability to complete 1 of the 12 activity items in basic activities of daily living (ADL) and instrumental ADL. The cognitive dimensions of episodic memory, attention/numerical ability, orientation to time, and visuospatial ability were assessed via the immediate/delayed recall task, serial sevens task, naming the current date and pentagon-figure-drawing tasks, respectively.Results Of 1022 older respondents with COPD at wave-4, 48.5% had ADL disability. Declines in the global cognitive function (β (95% CI)=−0.627 (−1.214 to –0.040)), orientation to time (β (95% CI)=−0.207 (−0.364 to –0.050)) and visuospatial ability (β (95% CI)=−0.068 (−0.127 to –0.009)) were significantly associated with the presence of ADL disability, when demographic and health-related variables were adjusted. Of 152 older participants with COPD and without ADL disability in wave-2, 61 (40.1 %) developed disability over a 2-year follow-up. Relative to the participants without a decline in orientation to tine, those with the condition had greater odds of incidence of ADL disability increased by a factor of about 1.46 over a 2-year follow-up.Conclusions In older adults with COPD, orientation to time and visuospatial inability are vulnerable to the presence of a disability. Prevention of a decline in orientation to time might help prevent disability in older people with COPD.https://bmjopen.bmj.com/content/10/10/e040098.full |
| spellingShingle | Chao Wu Bingyan Gong Shaomei Shang Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study BMJ Open |
| title | Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study |
| title_full | Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study |
| title_fullStr | Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study |
| title_full_unstemmed | Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study |
| title_short | Association between cognitive declines and disability in activities of daily living in older adults with COPD: evidence from the China health and retirement longitudinal study |
| title_sort | association between cognitive declines and disability in activities of daily living in older adults with copd evidence from the china health and retirement longitudinal study |
| url | https://bmjopen.bmj.com/content/10/10/e040098.full |
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