Associations of Pulmonary Function with MRI Brain Volumes: A Coordinated Multi-Study Analysis
Open accessAbstract
Background: Previous studies suggest poor pulmonary function is associated with increased burden of cerebral white matter hyperintensities and brain atrophy among elderly individuals, but the results are inconsistent. Objective: To study the cross-sectional associations of pulmonary function with structural brain variables. Methods: Data from six large community-based samples (N = 11,091) were analyzed. Spirometric measurements were standardized with respect to age, sex, height, and ethnicity using reference equations of the Global Lung Function Initiative. Associations of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and their ratio FEV1/FVC with brain volume, gray matter volume, hippocampal volume, and volume of white matter hyperintensities were investigated using multivariable linear regressions for each study separately and then combined using random-effect meta-analyses. Results: FEV1 and FVC were positively associated with brain volume, gray matter volume, and hippocampal volume, and negatively associated with white matter hyperintensities volume after multiple testing correction, with little heterogeneity present between the studies. For instance, an increase of FVC by one unit was associated with 3.5 ml higher brain volume (95% CI: [2.2, 4.9]). In contrast, results for FEV1/FVC were more heterogeneous across studies, with significant positive associations with brain volume, gray matter volume, and hippocampal volume, but not white matter hyperintensities volume. Associations of brain variables with both FEV1 and FVC were consistently stronger than with FEV1/FVC, specifically with brain volume and white matter hyperintensities volume. Conclusion: In cross-sectional analyses, worse pulmonary function is associated with smaller brain volumes and higher white matter hyperintensities burden.
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Population surveys show that poorer pulmonary function is associated with a decreased brain volume and increased white matter hyperintensity (WMH), and a 1-year increase in the lung biological age increases the brain biological age by 25 days.
“According to population surveys, poorer pulmonary function (PF) is associated with a decreased brain volume and increased white matter hyperintensity (WMH),262 and a 1-year increase in the lung BA increases the brain BA by 25 days.”
From Antiageing strategy for neurodegenerative diseases: from mechanisms to clinical advances (2025) · cites this paper as [262]
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- Authors
- Frenzel, S., Bis, J. C., Gudmundsson, E. F., O’Donnell, A., Simino, J., Yaqub, A., Bartz, T. M., Brusselle, G. G. O., Bülow, R., DeCarli, C. S., Ewert, R., Gharib, S. A., Ghosh, S., Gireud-Goss, M., Gottesman, R. F., Ikram, M. A., Knopman, D. S., Launer, L. J., London, S. J., Longstreth, W. T., Lopez, O. L., Melo van Lent, D., O’Connor, G., Satizabal, C. L., Shrestha, S., Sigurdsson, S., Stubbe, B., Talluri, R., Vasan, R. S., Vernooij, M. W., Völzke, H., Wiggins, K. L., Yu, B., Beiser, A. S., Gudnason, V., Mosley, T., Psaty, B. M., Wolters, F. J., Grabe, H. J., & Seshadri, S.
- Affiliations
- Universitätsmedizin Greifswald (DE)
- University of Washington (US)
- Icelandic Heart Association (IS)
- Boston University (US)
- University of Mississippi Medical Center (US)
- Erasmus MC (NL)
- University of California, Davis (US)
- Glenn Biggs Institute for Alzheimer and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, SanAntonio, TX, USA
- National Institutes of Health (US)
- Mayo Clinic (US)
- United States Department of Health and Human Services (US)
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
- Framingham Heart Study, Framingham, MA, USA
- The University of Texas Health Science Center at Houston (US)
- University of Iceland (IS)
- Corresponding author
- Frenzel, Stefan
- ORCID
- Frenzel, Stefan
- Bis, Joshua C.
- Gudmundsson, Elias F.
- O’Donnell, Adrienne
- Simino, Jeannette
- Yaqub, Amber
- Bartz, Traci M.
- Brusselle, Guy G. O.
- Bülow, Robin
- DeCarli, Charles S.
- Ewert, Ralf
- Gharib, Sina A.
- Ghosh, Saptaparni
- Gottesman, Rebecca F.
- Ikram, M. Arfan
- Knopman, David S.
- Launer, Lenore J.
- London, Stephanie J.
- O’Connor, George
- Shrestha, Srishti
- Sigurdsson, Sigurdur
- Stubbe, Beate
- Talluri, Rajesh
- Vasan, Ramachandran S.
- Vernooij, Meike W.
- Völzke, Henry
- Wiggins, Kerri L.
- Yu, Bing
- Beiser, Alexa S.
- Gudnason, Vilmundur
- Mosley, Thomas
- Psaty, Bruce M.
- Wolters, Frank J.
- Grabe, Hans J.
- Seshadri, Sudha
- Venue
- Journal of Alzheimer's Disease
- Publisher
- SAGE Publications
- Published
- 2022-11-22
- Volume
- 90
- Issue
- 3
- Pages
- 1073-1083
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- PMC
- PMC9712227
- OpenAlex
- W4300981025
- Cited by
- 22
- References
- 59
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 9 · 2023: 2
- FWCI
- 2.93
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Alzheimer s Disease (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (publishedVersion, other-oa)
- Opin vísindi (Opin vísindi) (submittedVersion, cc-by-nc-sa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by-nc)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
- Opin vísindi (Opin vísindi) (submittedVersion, other-oa)
- DZNE Pub (submittedVersion, other-oa)
- Funders
- National Institutes of Health
- National Institute on Aging (R01 AG059421, R01AG054076, RF1AG059421, P30AG066546)
- National Heart, Lung, and Blood Institute (R01HL105756)
- National Institute of Neurological Disorders and Stroke (R01NS017950)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
- Keywords
- lung function, brain volume
- MeSH terms
- Aged, Brain, Cross-Sectional Studies, Forced Expiratory Volume, Humans, Lung, Magnetic Resonance Imaging
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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