The association between spirometry measurement quality, cognitive function, and mortality.

Area of Science:

• Pulmonary Medicine
• Cognitive Neuroscience
• Epidemiology

Background:

• Population studies assessing lung function often exclude individuals with poor-quality spirometry measurements.
• Excluding subjects with poor-quality spirometry, frequently linked to impaired cognition, may introduce selection bias.
• This study investigates the relationship between spirometry quality, cognitive function, and mortality risk.

Purpose of the Study:

• To examine the association between cognitive function and spirometry quality.
• To determine if poor-quality spirometry independently predicts mortality risk.
• To assess the potential for selection bias in lung function studies.

Main Methods:

• Prospective cohort study of 12,087 individuals aged 45-75 years in Central and Eastern Europe.
• Cognitive function assessed using memory, verbal fluency, and executive function tests.
• Spirometry quality classified as good or poor; spirometry impairment assessed using FVC and FEV1.

Main Results:

• Higher cognitive function was associated with a lower likelihood of poor-quality spirometry (OR 0.82).
• Impaired spirometry was linked to increased mortality risk (aHR 1.63), even after adjusting for cognition.
• No significant difference in mortality risk was observed between poor-quality and good-quality spirometry groups.

Conclusions:

• Higher cognitive function is associated with better spirometry quality.
• Excluding poor-quality spirometry is unlikely to introduce significant bias in mortality risk analyses.
• Discarding poor-quality spirometry may lead to the exclusion of vulnerable populations; findings require confirmation in diverse populations.