Association Between Pulmonary Function, Respiratory Muscle Strength and Cognitive Function in Chinese Community-Dwelling Older Adults

Zhichao He,1,* Guirong Cheng,1,2,* Shiyue Li,3,* Feibo Zhao,1 Haishi Fei,1 Yan Zeng,1,2 Shengzhong Yi4 1Brain Science and Advanced Technology Institute, School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 2Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 3Department of Orthopedics, The Second Affiliated Hospital of Air Force Medical University, Xian, Shaanxi, People’s Republic of China; 4Hubei, Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shengzhong Yi, Hubei, Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Zhuodaoquan South Road, Hongshan District, Wuhan, 430079, People’s Republic of China, Email [email protected] Yan Zeng, Brain Science and Advanced Technology Institute, School of Medicine, Wuhan University of Science and Technology, West Huangjiahu Road, Hongshan District, Wuhan, 430065, People’s Republic of China, Email [email protected]: Decline in pulmonary function (PF) and respiratory muscle strength (RMS) is influenced by environmental and genetic factors and is inconsistently linked to cognitive outcomes. This study explores the associations between PF, RMS, and cognitive function among community-dwelling older adults in China, analyzing interactions with APOE Ɛ4 and the mediating effect of serum total bilirubin.Patients and Methods: About 1,081 Hubei Memory and Aging Cohort (HMACS) participants underwent PF (PEF, FEV1 and FVC), RMS (MIP and MEP) assessment, cognitive tests, APOE genotyping, and bilirubin measurement. Multivariate logistic regression and general linear regression were used to analyze associations.Results: Among 1,081 participants (mean age 70.52 ± 5.55 years), 26.1% had cognitive impairment. Lower PF and RMS scores were associated with cognitive impairment. Higher comprehensive PF (c-PF) and RMS indices protected against cognitive impairment (eg, c-PF: OR = 0.482– 0.609, P < 0.05; MEP: OR = 0.464, P = 0.005). PF and RMS indices correlated positively with global cognition, memory, language, and executive function. Sex differences were noted, with males (n = 449, 41.5%) showing associations between MIP/MEP and global cognition, memory, and language, while females (n = 632, 58.5%) showed broader associations. APOE Ɛ4 status (n = 330) did not affect these associations. Serum total bilirubin levels (n = 977) correlated with pulmonary and cognitive function but did not mediate the associations.Conclusion: PF (especially PEF) and RMS (especially MEP) indices are significantly associated with cognitive function and impairment in older adults, independent of APOE Ɛ4 status. These findings provide biomarkers for assessing cognitive health risk and a basis for interventions targeting PF and RMS to preserve cognitive function.Keywords: pulmonary function, respiratory muscle strength, cognitive impairment, cross-sectional study, older adults