Chronic obstructive pulmonary disease and cerebrovascular disease: A comprehensive review.
Along with the aging population, the public health burden of cerebrovascular disease is increasing. Cerebral small vessel disease and accumulation of brain pathology associate with cognitive decline and can lead to clinical outcomes, such as stroke and dementia. Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory disease among elderly. The quality of life and prognosis of patients with COPD is greatly determined by the presence of comorbidities including stroke and cognitive impairment. Despite the clinical relevance of cerebral small vessel disease, stroke and (vascular) cognitive impairment in patients with COPD, literature is scarce and underlying mechanisms are unknown. The aim of the present review is therefore to summarize current scientific knowledge, to provide a better understanding of the interplay between COPD and the aging brain and to define remaining knowledge gaps. This narrative review article 1) overviews the epidemiology of cerebral small vessel disease, stroke and cognitive impairment in patients with COPD; 2) discusses potential underlying mechanisms including aging, smoking, systemic inflammation, vasculopathy, hypoxia and genetic susceptibility; and 3) highlights areas requiring further research.
Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. Electronic address: lies.lahousse@ugent.be.
Lies
L
Lahousse
Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Henning
H
Tiemeier
Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Radiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
M Arfan
MA
Ikram
Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Respiratory Medicine, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
Guy G
GG
Brusselle
D035843:Biomedical Research / Q000379:methods / Q000639:trends; D002561:Cerebrovascular Disorders / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology / Q000534:rehabilitation; D011788:Quality of Life; D020521:Stroke / Q000453:epidemiology
Cerebral small vessel disease; Cerebrovascular disease; Chronic obstructive pulmonary disease; Cognitive impairment; Stroke