title: Association of Chronic Obstructive Pulmonary Disease With Increased Confusion or Memory Loss and Functional Limitations Among Adults in 21 States, 2011 Behavioral Risk Factor Surveillance System.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is associated with cognitive impairment, but consequences of this association on a person's functional limitations are unclear. We examined the association between COPD and increased confusion and memory loss (ICML) and functional limitations among adults with COPD.
  
  
  METHODS
  We studied adults aged 45 years or older in 21 states who participated in the 2011 Behavioral Risk Factor Surveillance System (n = 102,739). Presence of COPD was based on self-reported physician diagnosis. ICML was based on self-report that confusion or memory loss occurred more often or worsened during the prior year. ICML-associated difficulties were defined as giving up household chores and former activities, decreased ability to work or engage in social activities, or needing help from family or friends during the prior year due to ICML. General limitations were defined as needing special equipment as a result of a health condition, having had activity limitations for 2 weeks or more in the prior month, or being unable to work. Multivariable models were adjusted for demographics, health behaviors or conditions, and frequent mental distress.
  
  
  RESULTS
  COPD was reported by 9.3% of adults. ICML was greater among those with COPD than among those without COPD (25.8% vs 11%; adjusted prevalence ratio [aPR], 1.48; 95% confidence interval [CI], 1.32%-1.66%). People with COPD, either with or without ICML, were more likely than those without COPD to report general functional limitations. Among people reporting ICML, those with COPD were more likely to report interference with work or social activities than those without COPD (aPR, 1.17; 95% CI, 1.01%-1.36%).
  
  
  CONCLUSIONS
  Functional limitations were greater among those with COPD than among those without, and ICML may further affect these limitations. Results from our study can inform future studies of self- management and functional limitations for people with COPD.
authors.affiliation: Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, NE, Mailstop F73, Atlanta GA 30341-3717. Email: KGreenlund@cdc.gov.
authors.forename: Kurt J
authors.initials: KJ
authors.lastname: Greenlund
authors.affiliation: Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Deokar
authors.affiliation: Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Wheaton
authors.affiliation: Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia.
authors.forename: Janet B
authors.initials: JB
authors.lastname: Croft
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D003221:Confusion / Q000209:etiology*; D003625:Data Collection; D006801:Humans; D008569:Memory Disorders / Q000209:etiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology