Subjective Cognitive Decline in COPD - A Cross-Sectional Analysis of the Behavioral Risk Factor Surveillance System.

Background: Subjective cognitive decline (SCD), an early indicator of cognitive impairment, may affect COPD care and outcomes, yet its sociodemographic associations in Chronic Obstructive Pulmonary Disease (COPD) remain poorly understood.

Objective: To investigate the prevalence of SCD among people with COPD across different age groups and identify associations between demographics, risk behaviors, comorbidities, and self-reported SCD.

Design: Pooled 2019 BRFSS data from 24 states using the Cognitive Decline module were analyzed. Logistic regression assessed relationships between demographics, behaviors, comorbidities, and SCD, adjusting for confounders.

Participants: A total of 12,003 adults with COPD aged ≥ 45 were included in the study (weighted population = 617,792).

Main Measures: Prevalence of SCD, associations with demographics, behaviors, health status, income, employment, and smoking.

Key Results: Among adults with COPD, 24.1% reported SCD. The prevalence among those with SCD was highest in those aged 55-64 (30.2%), followed by 65-74 (24.5%) and 45-54 (23.1%). Older age (55 to 64: AOR = 0.63, 95% CI: 0.49 - 0.80; 65 to 74: AOR = 0.54, 95% CI: 0.40 - 0.72; 75 to 79: AOR = 0.41, 95% CI: 0.29 - 0.60; 80 + : AOR = 0.47, 95% CI: 0.32 - 0.69) and higher annual income (e.g., $25,000 to $49,999: AOR = 0.80, 95% CI: 0.65 - 0.99; $50,000 to $74,999: AOR = 0.68, 95% CI: 0.51 - 0.91) were associated with lower odds of reporting SCD, while unemployment (AOR = 1.73, 95% CI: 1.33 - 2.27), history of stroke (AOR = 1.35, 95% CI: 1.05 - 1.74), and fair or poor health (AOR = 0.47, 95% CI: 0.39 - 0.57) were linked to higher odds of reporting SCD.

Conclusions: Among adults with COPD, the prevalence of SCD varied by age, with the highest rates in those aged 55-64, and was independently associated with socioeconomic factors and health risks, emphasizing the complex interplay of demographic and health-related factors in SCD.