COPD and Cognitive Impairment: A Review of Associated Factors and 1 Intervention Strategies

Yuling Jing^*Shuixiang Mao

• Mianzhu People's Hospital, Mianzhu, China

Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a 11 systemic disorder associated with heightened risk of cognitive impairment, including 12 mild cognitive impairment (MCI) and dementia. Epidemiological studies indicate 13 COPD patients face a 1.74-fold higher risk of cognitive decline, with deficits 14 predominantly affecting attention, memory, and executive functions, impairing daily 15 living and increasing mortality risk. This review synthesizes factors linking COPD to 16 cognitive impairment, including systemic inflammation (via proinflammatory 17 cytokines and blood-brain barrier disruption), hypoxemia/hypercapnia (inducing 18 oxidative stress and neuronal damage), acute exacerbations (exacerbating 19 inflammation and persisting deficits), and comorbidities like obstructive sleep apnoea 20 (OSA), cerebral microbleeds, and depression. Smoking's role remains paradoxical, 21 with neurotoxicants potentially counteracted by nicotine's neuroprotective effects. 22 Assessment relies on neuropsychological tools (e.g., MoCA, MMSE), 23 neurophysiological measures (P300 ERP), and neuroimaging, though limitations 24 persist. Interventions focus on non-pharmacological strategies: pulmonary 25 rehabilitation (improving cognition via enhanced cerebral perfusion), cognitive 26 training (targeting memory/attention), and long-term oxygen therapy (LTOT, reducing 27 decline in hypoxemic patients). Critical gaps include unclear mechanisms and the 28 need for personalized interventions. Addressing these may improve clinical outcomes 29 and quality of life in COPD patients.