Journal article
Airway wall thickness and PRISm are associated with cognitive impairment in individuals with cigarette smoking exposure
Respiratory research
07/08/2026
DOI: 10.1186/s12931-026-03803-2
PMID: 42420978
Abstract
Individuals with chronic obstructive pulmonary disease (COPD) and cigarette smoking exposure are at increased risk of cognitive impairment; however, the clinical characteristics of those at risk are incompletely understood.
We conducted a secondary analysis of COPDGene cohort data to identify clinical characteristics, particularly pulmonary function and lung CT metrics, associated with cognitive impairment. Cognitive items available from Phase 3 included: self-report of a cognitive disorder diagnosis and cognitive difficulties, and probable cognitive impairment (pCI) defined by Mini-Cog ≤ 3. Thirty-seven variables were considered for inclusion in a mixed effects logistic regression with pCI as the dependent variable including demographics, smoking history, medical history, symptom severity, pulmonary function testing, and COPD-related lung CT variables.
Among 2,079 participants (mean age = 68.7[SD ± 8.6] years, 51.2% female, 28.7% African American), the frequency of pCI differed by smoking/COPD severity group (9.4% never smokers, 18.7% smoking history-normal spirometry, 30.0% preserved ratio impaired spirometry [PRISm], 26.3% GOLD 1-4; p < 0.001). Older age, male sex, lower education, African American race, lower body mass index, higher anxiety symptoms, and CT metrics (higher Perc15 and Pi10) were associated with pCI in the final model.
Just under thirty percent of participants with smoking exposure and evidence of lung disease on spirometry (PRISm or GOLD 1-4) had pCI, with the highest frequency in PRISm and advanced COPD. Several demographic and clinical characteristics were associated with pCI including airway disease measured via Pi10 on lung CT pointing to a potential link between specific COPD-related physiology and cognitive impairment.
Details
- Title: Subtitle
- Airway wall thickness and PRISm are associated with cognitive impairment in individuals with cigarette smoking exposure
- Creators
- Karin F Hoth - University of IowaCarinda Linkenmeyer - University of IowaGregory L Kinney - University of Colorado Anschutz Medical CampusJohn D Newell Jr - University of Iowa, RadiologyElizabeth A Regan - National Jewish HealthBarry Make - National Jewish HealthKatherine A Pratte - National Jewish HealthAlejandro P Comellas - University of IowaEric A Hoffman - University of IowaSpyridon Fortis - University of IowaJess G Fiedorowicz - University of OttawaDawn L DeMeo - Brigham and Women's HospitalAbebaw M Yohannes - University of Alabama at BirminghamAnand S Iyer - University of Alabama at BirminghamMarilyn G Foreman - Morehouse School of MedicineSurya P Bhatt - University of Alabama at BirminghamKen M Kunisaki - Minneapolis VA Health Care SystemSharon M Lutz - Harvard Pilgrim Health CareEdwin K Silverman - Harvard UniversityJames D Crapo - National Jewish HealthErin Austin - University of Colorado Denver
- Resource Type
- Journal article
- Publication Details
- Respiratory research
- DOI
- 10.1186/s12931-026-03803-2
- PMID
- 42420978
- ISSN
- 1465-993X
- eISSN
- 1465-993X
- Publisher
- Springer Nature
- Grant note
- R01MH129337 / NIH HHS R01 HL134822 / NIH HHS U01HL089897, U01HL089856, 75N92023D00011 / NIH HHS
- Language
- English
- Electronic publication date
- 07/08/2026
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; Psychiatry; ICTS; Epidemiology; Iowa Neuroscience Institute; Internal Medicine
- Record Identifier
- 9985180789002771
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