Prevalence of cognitive impairment in patients with chronic obstructive pulmonary disease: a meta-analysis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHU Jieyun ¹ , HE Cuiying ² , LU Zhao ¹ , YE Changguang ³ , CAI Zhaoqiang ³ , HUANG Chunli ¹ , PAN Dongzan ¹ ,  SHEN Yin ¹

1. International Medical Services, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021, P.R.China;
2. Guangxi Medical University, Nanning, Guangxi 530007, P.R. China;
3. Department of Respiratory and Critical Care Medicine, HePu People's Hospital, Hepu, Guangxi 536100, P.R. China;

Corresponding author：

SHEN Yin, Email: sy_doctor@sina.cn

Keywords：

Chronic obstructive pulmonary disease; Cognitive impairment; Prevalence; Meta-analysis

DOI：

10.7507/1671-6205.202309064

Video：

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Objective To systematically analyze the prevalence of cognitive impairment in patients with COPD.Methods An electronic search in PubMed, Embase, CNKI, WanFang Data and VIP databases to identify studies describing the prevalence of cognitive impairment in patients with COPD from inception to 3 May 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, the meta-analysis was performed by using Stata16.0 software. Results A total of 40 studies involving 9, 988 patients with COPD were included. Meta-analysis showed that the total prevalence of cognitive impairment in patients with COPD was 48.26% (95%CI 42.39% to 54.20%). The results of subgroup analysis revealed that the prevalence of cognitive impairment in patients with acute exacerbation of COPD was higher than that in patients with stable-phase (58.62% vs. 49.71%). The prevalence of cognitive impairment in COPD patients was 29.07% before 2015, while the prevalence between 2015-2019 and 2020-2023 were higher, with rates of 53.06% and 48.26% respectively. The prevalence of cognitive impairment in domestic COPD patients was significantly higher than that in foreign patients (52.66% vs. 37.06%). Conclusion The prevalence of cognitive impairment is relatively high in COPD patients, highlighting the need to strengthen the screening for cognitive impairment in COPD patients and provide early assessment and intervention.

Citation： ZHU Jieyun, HE Cuiying, LU Zhao, YE Changguang, CAI Zhaoqiang, HUANG Chunli, PAN Dongzan, SHEN Yin. Prevalence of cognitive impairment in patients with chronic obstructive pulmonary disease: a meta-analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2024, 23(9): 625-633. doi: 10.7507/1671-6205.202309064 Copy

1.	常潇丹, 黄丹辉, 蔡绍曦. 慢性阻塞性肺疾病合并症——认知障碍. 中国临床新医学, 2021, 14(4): 333-339.
2.	Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. https: //goldcopd. org/2021-gold-reports.
3.	罗晨阳, 何志义. 慢性阻塞性肺疾病与合并症. 结核与肺部疾病杂志, 2023, 4(05): 407-412.
4.	Chang SS, Chen S, McAvay GJ, et al. Effect of coexisting chronic obstructive pulmonary disease and cognitive impairment on health outcomes in older adults. J Am Geriatr Soc. 2012, 60(10): 1839-1846.
5.	高志欣, 贠相华, 王宏艳. 慢性阻塞性肺疾病急性加重期患者认知障碍临床分析. 齐齐哈尔医学院学报, 2016, 37(9): 1145-1147.
6.	方蒡, 牛华, 张芹, 等. 老年慢性阻塞性肺疾病患者认知变化及影响因素分析. 中国社区医师, 2017, 33(9): 71-72.
7.	王兰, 江莲, 唐良法, 等. 慢性阻塞性肺疾病患者急性加重期认知功能障碍相关因素分析. 中华老年医学杂志, 2015, 34(4): 391-393.
8.	Yohannes AM, Chen W, Moga AM, et al. Cognitive Impairment in Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: A Systematic Review and Meta-analysis of Observational Studies. J Am Med Dir Assoc, 2017, 18(5): 451.e1-451. e1-451.
9.	朱晓颖, 刘聪辉, 戈艳蕾, 等. 慢性阻塞性肺疾病患者血清8-羟基脱氧鸟苷酸、内皮素-1水平与认知功能障碍的相关性. 中国呼吸与危重监护杂志, 2019, 18(1): 10-14.
10.	苗玲, 王敏, 秦景云, 等. 血清同型半胱氨酸和半胱氨酸天冬酶-3水平与慢性阻塞性肺疾病患者认知障碍的关系研究. 实用心脑肺血管病杂志, 2020, 28(02): 53-57.
11.	蒋泽文, 钟金, 刘贤文, 等. 血清25(OH)D、SAA、Hcy水平对慢性阻塞性肺疾病患者认知障碍的诊断价值. 检验医学与临床, 2022, 19(18): 2463-2466.
12.	曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志. 2012, 4 (4): 297-299.
13.	何胜东, 杨树栋, 文礼, 等. 6MWD与慢性阻塞性肺疾病患者认知功能受损相关性研究. 国际呼吸杂志, 2020, 40(23): 1791-1795.
14.	于冰, 孙艳华. 慢性阻塞性肺疾病患者血浆NGAL、ET-1水平变化及其与认知功能障碍的关系. 山东医药, 2018, 58(25): 78-80.
15.	沙正凯, 蒋燕升, 张祥杰, 等. 慢性阻塞性肺疾病急性加重期伴发认知功能障碍的影响因素. 临床心身疾病杂志, 2019, 25(5): 101-104.
16.	裴嘉宇. 慢性阻塞性肺疾病患者轻度认知障碍风险预警模型的构建.山西医科大学, 2021.
17.	孙志峰, 冯丽芳, 李雪, 等. 老年慢性阻塞性肺疾病患者认知功能障碍调查. 中国医药导报, 2013, 10(08): 130-131.
18.	高宝银. 稳定期慢性阻塞性肺疾病患者认知功能相关因素研究. 河北医学, 2015, 21(06): 887-891.
19.	李艳. 老年慢性阻塞性肺疾病患者的认知功能评价及其相关影响因素分析. 延安大学, 2017.
20.	葛洁明, 岳淑玲, 贾红光, 等. 慢性阻塞性肺疾病患者认知功能状况及影响因素分析. 中国病案, 2017, 18(10): 105-109.
21.	韩英明, 尚祥. 慢性阻塞性肺疾病患者认知功能障碍危险因素调查. 中国乡村医药, 2018, 25(8): 16-17.
22.	刘亚男. 慢性阻塞性肺疾病患者认知功能状况及影响因素研究. 湖南师范大学, 2018.
23.	刘聪辉, 戈艳蕾, 李真真, 等. 血清IL-17、HCY水平对COPD患者认知功能损伤的诊断效能. 中国老年学杂志, 2019, 39(8): 1866-1868.
24.	闫俊毅. 同型半胱氨酸与COPD患者轻度认知功能障碍的相关性研究. 青海大学, 2019.
25.	马肖龙, 朱晓东, 戴利菊, 等. 慢性阻塞性肺疾病患者认知功能障碍与维生素D的关系研究. 中国现代医生, 2019, 57(19): 13-17.
26.	张改明. 老年COPD患者认知功能水平及其与血浆S-100β和Hcy的相关性研究. 继续医学教育, 2019, 33(09): 101-103.
27.	胡先纬, 涂友慧, 祝清清, 等. 慢性阻塞性肺疾病病患的认知功能探讨. 临床肺科杂志, 2020, 25(04): 505-509.
28.	王文静. 慢性阻塞性肺疾病患者认知功能障碍及脑功能改变的研究. 南昌大学, 2020.
29.	谢星, 徐翠容, 贾坤林. COPD患者血清HIF-1α、caspase-3、Hcy水平与认知功能损伤关系. 医学信息, 2021, 34(12): 97-100.
30.	牛丽红, 张晓黎, 王晓娜. 慢性阻塞性肺疾病稳定期患者认知功能障碍影响因素. 临床心身疾病杂志, 2021, 27(5): 63-66.
31.	员新昊. 慢性阻塞性肺疾病稳定期患者的病情严重程度与认知功能关系的研究. 承德医学院, 2022.
32.	陈柏茹, 陈贵华, 李琴. COPD患者认知功能障碍影响因素模型研究. 现代医药卫生, 2022, 38(10): 1639-1644.
33.	曹瑞莲, 侯会娜. 慢性阻塞性肺疾病患者认知功能调查及影响因素. 中国卫生工程学, 2021, 20(2): 242-243.
34.	Incalzil RA, Bellia V, Maggi S, et al. Salute Respiratoria nell’ Anziano Study Group. Mild to moderate chronic airways disease does not carry an excess risk of cognitive dysfunction. Aging Clin Exp Res, 2002, 14: 395e401.
35.	Antonelli-Incalzi R, Corsonello A, Pedone C, et al. Drawing impairment predicts mortality in severe COPD. Chest, 2006, 130(6): 1687-1694.
36.	Singh B, Parsaik AK, Mielke MM, et al. Chronic obstructive pulmonary disease and association with mild cognitive impairment: the Mayo Clinic Study of Aging. Mayo Clin Proc, 2013, 88(11): 1222-1230.
37.	Dal Negro RW, Bonadiman L, Tognella S, et al. Extent and prevalence of cognitive dysfunction in chronic obstructive pulmonary disease, chronic non-obstructive bronchitis, and in asymptomatic smokers, compared to normal reference values. Int J Chron Obstruct Pulmon Dis, 2014, 9: 675-683.
38.	Martinez CH, Richardson CR, Han MK, et al. Chronic obstructive pulmonary disease, cognitive impairment, and development of disability: the health and retirement study. Ann Am Thorac Soc, 2014, 11(9): 1362-1370.
39.	Dulohery MM, Schroeder DR, Benzo RP. Cognitive function and living situation in COPD: is there a relationship with self-management and quality of life? Int J Chron Obstruct Pulmon Dis, 2015, 10: 1883-1889.
40.	Ozyemisci-Taskiran O, Bozkurt SO, Kokturk N, et al. Is there any association between cognitive status and functional capacity during exacerbation of chronic obstructive pulmonary disease? Chron Respir Dis, 2015, 12(3): 247-255.
41.	Schure MB, Borson S, Nguyen HQ, et al. Associations of cognition with physical functioning and health-related quality of life among COPD patients. Respir Med, 2016, 114: 46-52.
42.	Cleutjens FAHM, Spruit MA, Ponds RWHM, et al. Cognitive impairment and clinical characteristics in patients with chronic obstructive pulmonary disease. Chron Respir Dis, 2018, 15(2): 91-102.
43.	Charbek E, Huynh K, Kim E, et al. Assessment of Cognitive Impairment in Patients with Chronic Obstructive Pulmonary Disease Using the Rapid Cognitive Screen. J Nutr Health Aging, 2019, 23(1): 102-104.
44.	Wang Y, Li B, Li P, et al. Severe obstructive sleep apnea in patients with chronic obstructive pulmonary disease is associated with an increased prevalence of mild cognitive impairment. Sleep Med, 2020, 75: 522-530.
45.	Ozturk HM, Ogan N, Erdogan M, et al. The association between total cholesterol and cognitive impairment in chronic obstructive pulmonary disease patients. Prostaglandins Other LipidMediat, 2023, 164: 106697.
46.	Roncero C, Campuzano AI, Quintano JA, et al. Cognitive status among patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2016, 11: 543-551.
47.	Siraj RA, McKeever TM, Gibson JE, et al. Risk of incident dementia and cognitive impairment in patients with chronic obstructive pulmonary disease (COPD): A large UK population-based study [published online ahead of print, 2020 Dec 24]. Respir Med, 2020, 177: 106288.
48.	赵启凤, 熊家义, 张国强, 等. 慢性阻塞性肺疾病患者轻度认知功能障碍的相关影响因素. 海南医学, 2017, 28(23): 3813-3815.
49.	Dodd JW. Lung disease as a determinant of cognitive decline and dementia. Alzheimers Res Ther, 2015, 7(1): 32.
50.	Xie F, Xie L. COPD and the risk of mild cognitive impairment and dementia: a cohort study based on the Chinese Longitudinal Health Longevity Survey. Int J Chron Obstruct Pulmon Dis, 2019, 14: 403-408.
51.	Schou L, Østergaard B, Rasmussen LS, et al. Cognitive dysfunction in patients with chronic obstructive pulmonary disease--a systematic review. Respir Med. 2012, 106(8): 1071-1081.
52.	解恒革. 积极推进认知障碍的社区筛查. 中华老年心脑血管病杂志, 2022, 24(8): 785-788.
53.	范金, 钟冬灵, 李涓, 等. 中国2型糖尿病患者认知障碍检出率的Meta分析. 中国循证医学杂志, 2021, 21(7): 787-795.
54.	Dodd JW, Charlton RA, van den Broek MD, et al. Cognitive dysfunction in patients hospitalized with acute exacerbation of COPD. Chest, 2013, 144(1): 119-127.
55.	Beydoun MA, Beydoun HA, Gamaldo AA, et al. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health, 2014, 14: 643.
56.	Swan GE, Lessov-Schlaggar CN. The effects of tobacco smoke and nicotine on cognition and the brain. Neuropsychol Rev, 2007, 17(3): 259-273.
57.	Ling J, Heffernan T. The Cognitive Deficits Associated with Second-Hand Smoking. Front Psychiatry, 2016, 7: 46.

1. 常潇丹, 黄丹辉, 蔡绍曦. 慢性阻塞性肺疾病合并症——认知障碍. 中国临床新医学, 2021, 14(4): 333-339.
2. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. https: //goldcopd. org/2021-gold-reports.
3. 罗晨阳, 何志义. 慢性阻塞性肺疾病与合并症. 结核与肺部疾病杂志, 2023, 4(05): 407-412.
4. Chang SS, Chen S, McAvay GJ, et al. Effect of coexisting chronic obstructive pulmonary disease and cognitive impairment on health outcomes in older adults. J Am Geriatr Soc. 2012, 60(10): 1839-1846.
5. 高志欣, 贠相华, 王宏艳. 慢性阻塞性肺疾病急性加重期患者认知障碍临床分析. 齐齐哈尔医学院学报, 2016, 37(9): 1145-1147.
6. 方蒡, 牛华, 张芹, 等. 老年慢性阻塞性肺疾病患者认知变化及影响因素分析. 中国社区医师, 2017, 33(9): 71-72.
7. 王兰, 江莲, 唐良法, 等. 慢性阻塞性肺疾病患者急性加重期认知功能障碍相关因素分析. 中华老年医学杂志, 2015, 34(4): 391-393.
8. Yohannes AM, Chen W, Moga AM, et al. Cognitive Impairment in Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: A Systematic Review and Meta-analysis of Observational Studies. J Am Med Dir Assoc, 2017, 18(5): 451.e1-451. e1-451.
9. 朱晓颖, 刘聪辉, 戈艳蕾, 等. 慢性阻塞性肺疾病患者血清8-羟基脱氧鸟苷酸、内皮素-1水平与认知功能障碍的相关性. 中国呼吸与危重监护杂志, 2019, 18(1): 10-14.
10. 苗玲, 王敏, 秦景云, 等. 血清同型半胱氨酸和半胱氨酸天冬酶-3水平与慢性阻塞性肺疾病患者认知障碍的关系研究. 实用心脑肺血管病杂志, 2020, 28(02): 53-57.
11. 蒋泽文, 钟金, 刘贤文, 等. 血清25(OH)D、SAA、Hcy水平对慢性阻塞性肺疾病患者认知障碍的诊断价值. 检验医学与临床, 2022, 19(18): 2463-2466.
12. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志. 2012, 4 (4): 297-299.
13. 何胜东, 杨树栋, 文礼, 等. 6MWD与慢性阻塞性肺疾病患者认知功能受损相关性研究. 国际呼吸杂志, 2020, 40(23): 1791-1795.
14. 于冰, 孙艳华. 慢性阻塞性肺疾病患者血浆NGAL、ET-1水平变化及其与认知功能障碍的关系. 山东医药, 2018, 58(25): 78-80.
15. 沙正凯, 蒋燕升, 张祥杰, 等. 慢性阻塞性肺疾病急性加重期伴发认知功能障碍的影响因素. 临床心身疾病杂志, 2019, 25(5): 101-104.
16. 裴嘉宇. 慢性阻塞性肺疾病患者轻度认知障碍风险预警模型的构建.山西医科大学, 2021.
17. 孙志峰, 冯丽芳, 李雪, 等. 老年慢性阻塞性肺疾病患者认知功能障碍调查. 中国医药导报, 2013, 10(08): 130-131.
18. 高宝银. 稳定期慢性阻塞性肺疾病患者认知功能相关因素研究. 河北医学, 2015, 21(06): 887-891.
19. 李艳. 老年慢性阻塞性肺疾病患者的认知功能评价及其相关影响因素分析. 延安大学, 2017.
20. 葛洁明, 岳淑玲, 贾红光, 等. 慢性阻塞性肺疾病患者认知功能状况及影响因素分析. 中国病案, 2017, 18(10): 105-109.
21. 韩英明, 尚祥. 慢性阻塞性肺疾病患者认知功能障碍危险因素调查. 中国乡村医药, 2018, 25(8): 16-17.
22. 刘亚男. 慢性阻塞性肺疾病患者认知功能状况及影响因素研究. 湖南师范大学, 2018.
23. 刘聪辉, 戈艳蕾, 李真真, 等. 血清IL-17、HCY水平对COPD患者认知功能损伤的诊断效能. 中国老年学杂志, 2019, 39(8): 1866-1868.
24. 闫俊毅. 同型半胱氨酸与COPD患者轻度认知功能障碍的相关性研究. 青海大学, 2019.
25. 马肖龙, 朱晓东, 戴利菊, 等. 慢性阻塞性肺疾病患者认知功能障碍与维生素D的关系研究. 中国现代医生, 2019, 57(19): 13-17.
26. 张改明. 老年COPD患者认知功能水平及其与血浆S-100β和Hcy的相关性研究. 继续医学教育, 2019, 33(09): 101-103.
27. 胡先纬, 涂友慧, 祝清清, 等. 慢性阻塞性肺疾病病患的认知功能探讨. 临床肺科杂志, 2020, 25(04): 505-509.
28. 王文静. 慢性阻塞性肺疾病患者认知功能障碍及脑功能改变的研究. 南昌大学, 2020.
29. 谢星, 徐翠容, 贾坤林. COPD患者血清HIF-1α、caspase-3、Hcy水平与认知功能损伤关系. 医学信息, 2021, 34(12): 97-100.
30. 牛丽红, 张晓黎, 王晓娜. 慢性阻塞性肺疾病稳定期患者认知功能障碍影响因素. 临床心身疾病杂志, 2021, 27(5): 63-66.
31. 员新昊. 慢性阻塞性肺疾病稳定期患者的病情严重程度与认知功能关系的研究. 承德医学院, 2022.
32. 陈柏茹, 陈贵华, 李琴. COPD患者认知功能障碍影响因素模型研究. 现代医药卫生, 2022, 38(10): 1639-1644.
33. 曹瑞莲, 侯会娜. 慢性阻塞性肺疾病患者认知功能调查及影响因素. 中国卫生工程学, 2021, 20(2): 242-243.
34. Incalzil RA, Bellia V, Maggi S, et al. Salute Respiratoria nell’ Anziano Study Group. Mild to moderate chronic airways disease does not carry an excess risk of cognitive dysfunction. Aging Clin Exp Res, 2002, 14: 395e401.
35. Antonelli-Incalzi R, Corsonello A, Pedone C, et al. Drawing impairment predicts mortality in severe COPD. Chest, 2006, 130(6): 1687-1694.
36. Singh B, Parsaik AK, Mielke MM, et al. Chronic obstructive pulmonary disease and association with mild cognitive impairment: the Mayo Clinic Study of Aging. Mayo Clin Proc, 2013, 88(11): 1222-1230.
37. Dal Negro RW, Bonadiman L, Tognella S, et al. Extent and prevalence of cognitive dysfunction in chronic obstructive pulmonary disease, chronic non-obstructive bronchitis, and in asymptomatic smokers, compared to normal reference values. Int J Chron Obstruct Pulmon Dis, 2014, 9: 675-683.
38. Martinez CH, Richardson CR, Han MK, et al. Chronic obstructive pulmonary disease, cognitive impairment, and development of disability: the health and retirement study. Ann Am Thorac Soc, 2014, 11(9): 1362-1370.
39. Dulohery MM, Schroeder DR, Benzo RP. Cognitive function and living situation in COPD: is there a relationship with self-management and quality of life? Int J Chron Obstruct Pulmon Dis, 2015, 10: 1883-1889.
40. Ozyemisci-Taskiran O, Bozkurt SO, Kokturk N, et al. Is there any association between cognitive status and functional capacity during exacerbation of chronic obstructive pulmonary disease? Chron Respir Dis, 2015, 12(3): 247-255.
41. Schure MB, Borson S, Nguyen HQ, et al. Associations of cognition with physical functioning and health-related quality of life among COPD patients. Respir Med, 2016, 114: 46-52.
42. Cleutjens FAHM, Spruit MA, Ponds RWHM, et al. Cognitive impairment and clinical characteristics in patients with chronic obstructive pulmonary disease. Chron Respir Dis, 2018, 15(2): 91-102.
43. Charbek E, Huynh K, Kim E, et al. Assessment of Cognitive Impairment in Patients with Chronic Obstructive Pulmonary Disease Using the Rapid Cognitive Screen. J Nutr Health Aging, 2019, 23(1): 102-104.
44. Wang Y, Li B, Li P, et al. Severe obstructive sleep apnea in patients with chronic obstructive pulmonary disease is associated with an increased prevalence of mild cognitive impairment. Sleep Med, 2020, 75: 522-530.
45. Ozturk HM, Ogan N, Erdogan M, et al. The association between total cholesterol and cognitive impairment in chronic obstructive pulmonary disease patients. Prostaglandins Other LipidMediat, 2023, 164: 106697.
46. Roncero C, Campuzano AI, Quintano JA, et al. Cognitive status among patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2016, 11: 543-551.
47. Siraj RA, McKeever TM, Gibson JE, et al. Risk of incident dementia and cognitive impairment in patients with chronic obstructive pulmonary disease (COPD): A large UK population-based study [published online ahead of print, 2020 Dec 24]. Respir Med, 2020, 177: 106288.
48. 赵启凤, 熊家义, 张国强, 等. 慢性阻塞性肺疾病患者轻度认知功能障碍的相关影响因素. 海南医学, 2017, 28(23): 3813-3815.
49. Dodd JW. Lung disease as a determinant of cognitive decline and dementia. Alzheimers Res Ther, 2015, 7(1): 32.
50. Xie F, Xie L. COPD and the risk of mild cognitive impairment and dementia: a cohort study based on the Chinese Longitudinal Health Longevity Survey. Int J Chron Obstruct Pulmon Dis, 2019, 14: 403-408.
51. Schou L, Østergaard B, Rasmussen LS, et al. Cognitive dysfunction in patients with chronic obstructive pulmonary disease--a systematic review. Respir Med. 2012, 106(8): 1071-1081.
52. 解恒革. 积极推进认知障碍的社区筛查. 中华老年心脑血管病杂志, 2022, 24(8): 785-788.
53. 范金, 钟冬灵, 李涓, 等. 中国2型糖尿病患者认知障碍检出率的Meta分析. 中国循证医学杂志, 2021, 21(7): 787-795.
54. Dodd JW, Charlton RA, van den Broek MD, et al. Cognitive dysfunction in patients hospitalized with acute exacerbation of COPD. Chest, 2013, 144(1): 119-127.
55. Beydoun MA, Beydoun HA, Gamaldo AA, et al. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health, 2014, 14: 643.
56. Swan GE, Lessov-Schlaggar CN. The effects of tobacco smoke and nicotine on cognition and the brain. Neuropsychol Rev, 2007, 17(3): 259-273.
57. Ling J, Heffernan T. The Cognitive Deficits Associated with Second-Hand Smoking. Front Psychiatry, 2016, 7: 46.

Chinese Journal of Respiratory and Critical Care Medicine

Prevalence of cognitive impairment in patients with chronic obstructive pulmonary disease: a meta-analysis

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