Table 2.
Lung Disease Categories, Objective Indices of Lung Function, and Risk of Incident Dementia: ARIC Study, 1996–2013
| Lung Disease Category |
||||||
|---|---|---|---|---|---|---|
| Normal | Respiratory Symptoms with Normal Spirometric Results | Restrictive Impairment Pattern | COPD Pattern | |||
| n | 6,108 | 4,754 | 832 | 2,490 |
||
| Dementia cases, n | 616 | 483 | 79 | 229 |
||
| Person-years | 130,103 | 96,713 | 15,485 | 46,012 |
||
| Incidence rate* | 4.7 | 5.0 | 5.1 | 5.0 |
||
| Hazard ratio (95% CI) | |
|||||
| Model 1 | 1 | 1.10 (0.97–1.24) | 1.31 (1.03–1.66) | 1.23 (1.06–1.43) |
||
| Model 2 | 1 | 1.06 (0.94–1.20) | 1.24 (0.97–1.57) | 1.11 (0.94–1.31) |
||
| Model 3 | 1 | 0.99 (0.88–1.12) | 0.99 (0.78–1.27) | 1.08 (0.92–1.28) |
||
| Model 4 | 1 | 0.99 (0.87–1.12) | 0.99 (0.78–1.27) | 1.08 (0.92–1.27) | ||
| FEV1% Predicted |
||||||
|---|---|---|---|---|---|---|
| Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | Trend (per 1 SD Decrease) | |
| n | 2,836 | 2,838 | 2,837 | 2,837 | 2,836 | |
| Dementia cases, n | 275 | 282 | 246 | 290 | 314 | |
| Person-years | 50,632 | 57,102 | 59,400 | 60,115 | 61,066 | |
| Incidence rate* | 5.4 | 4.9 | 4.1 | 4.8 | 5.1 | |
| Hazard ratio (95% CI) | ||||||
| Model 1 | 1.36 (1.15–1.60) | 1.12 (0.95–1.32) | 0.92 (0.77–1.08) | 1.08 (0.92–1.26) | 1 | 1.13 (1.07–1.19) |
| Model 2 | 1.23 (1.04–1.47) | 1.07 (0.91–1.26) | 0.89 (0.75–1.06) | 1.07 (0.91–1.25) | 1 | 1.09 (1.03–1.15) |
| Model 3 | 1.10 (0.93–1.32) | 0.98 (0.83–1.16) | 0.83 (0.70–0.99) | 1.02 (0.86–1.19) | 1 | 1.05 (0.98–1.11) |
| Model 4 | 1.11 (0.93–1.32) | 0.99 (0.83–1.16) | 0.84 (0.71–0.99) | 1.02 (0.87–1.20) | 1 | 1.05 (0.98–1.11) |
| FVC% Predicted |
||||||
|---|---|---|---|---|---|---|
| Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | Trend (per 1 SD Decrease) | |
| n | 2,836 | 2,838 | 2,835 | 2,839 | 2,836 | |
| Dementia cases, n | 283 | 292 | 257 | 297 | 278 | |
| Person-years | 52,072 | 56,824 | 58,743 | 59,860 | 60,815 | |
| Incidence rate* | 5.4 | 5.1 | 4.4 | 5.0 | 4.6 | |
| Hazard ratio (95% CI) | ||||||
| Model 1 | 1.44 (1.22–1.70) | 1.29 (1.09–1.52) | 1.10 (0.93–1.30) | 1.24 (1.06–1.47) | 1 | 1.12 (1.08–1.19) |
| Model 2 | 1.36 (1.14–1.61) | 1.25 (1.06–1.47) | 1.08 (0.91–1.28) | 1.24 (1.05–1.46) | 1 | 1.11 (1.04–1.17) |
| Model 3 | 1.14 (0.96–1.36) | 1.19 (1.00–1.40) | 0.99 (0.83–1.17) | 1.17 (0.99–1.38) | 1 | 1.06 (1.00–1.11) |
| Model 4 | 1.15 (0.96–1.37) | 1.20 (1.01–1.42) | 1.00 (0.84–1.19) | 1.18 (1.00–1.39) | 1 | 1.06 (1.00–1.11) |
| FEV1/FVC% Predicted |
||||||
|---|---|---|---|---|---|---|
| Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | Trend (per 1 SD Decrease) | |
| n | 2,836 | 2,838 | 2,837 | 2,835 | 2,838 | |
| Dementia cases, n | 257 | 247 | 266 | 287 | 350 | |
| Person-years | 52,834 | 58,333 | 59,125 | 59,380 | 58,652 | |
| Incidence rate* | 4.9 | 4.2 | 4.5 | 4.8 | 6.0 | |
| Hazard ratio (95% CI) | ||||||
| Model 1 | 0.97 (0.83–1.15) | 0.83 (0.70–0.98) | 0.84 (0.72–0.99) | 0.91 (0.78–1.06) | 1 | 1.03 (0.97–1.08) |
| Model 2 | 0.87 (0.73–1.03) | 0.79 (0.67–0.93) | 0.82 (0.70–0.97) | 0.90 (0.77–1.05) | 1 | 0.99 (0.92–1.05) |
| Model 3 | 0.93 (0.78–1.10) | 0.85 (0.72–1.00) | 0.87 (0.74–1.03) | 0.94 (0.80–1.10) | 1 | 1.00 (0.94–1.06) |
| Model 4 | 0.93 (0.78–1.10) | 0.85 (0.72–1.00) | 0.88 (0.75–1.04) | 0.94 (0.80–1.10) | 1 | 1.00 (0.94–1.06) |
Definition of abbreviations: ARIC = Atherosclerosis Risk in Communities; CI = confidence interval; COPD = chronic obstructive pulmonary disease.
Model 1: Cox regression adjusted for age, sex, center, education level, and race–center (five-level variable). Model 2: model 1 + additional adjustment for cigarette smoking and pack-years of smoking. Model 3: model 2 + additional adjustment for physical activity, body mass index, systolic blood pressure, blood pressure medication use, diabetes, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipid-lowering medications, prevalent coronary heart disease, heart failure, stroke, and apolipoprotein E genotype. Model 4: model 3 + fibrinogen.
Per 1,000 person-years.