{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T21:31:44Z","timestamp":1784151104188,"version":"3.55.0"},"reference-count":44,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003033","name":"Ministerio de Ciencia, Tecnolog\u00eda e Innovaci\u00f3n","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003033","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Chron Respir Dis"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the general population without COPD, indoor air pollution from biomass is a causal factor of cognitive impairment (CI). CI is also common in patients with tobacco smoke COPD and has been associated with hypoxemia and cardiovascular comorbidities. CI and its risk factors have not been evaluated in COPD patients living at high altitude, who experience greater hypoxemia and frequent exposure to wood smoke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with COPD residing at high altitude with FEV1\/FVC &lt;0,70 and COPD risk factors (wood smoke, Tobacco smoke or combined exposure). Measurement of the Mini-Mental State Examination to assess CI, educational level, comorbidities, exacerbations, arterial blood gases, diffusion (DLCO), and 6-min walk test (6MWT). Comparisons between groups with and without CI using the X2 test and unpaired t-test. Logistic regression with odds ratio (OR) calculation was used to evaluate the association of CI with the variables of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the 199 patients included, 16.1% had CI, the majority with mild involvement (68.8%). Those with CI had more frequent exposure to wood smoke (p&lt;0.001), older age (p=0.017), lower educational level, PaO2 (p=0.032), DLCO (p=0.036), and fewer meters in the 6MWT (p=0.007), with no differences in sex, severity of obstruction or comorbidities. Adjusting for the other variables, exposure to wood smoke was associated with CI [OR and 95% CI: 4.82 (1.62-14.33).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with mild to moderate COPD living at high altitude, regardless of hypoxemia, age, educational level, comorbidities, and lung function, exposure to wood smoke was associated with CI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14799731261462164","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T23:51:54Z","timestamp":1781740314000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Exposure to indoor wood smoke, rather than hypoxemia, is a risk factor for cognitive impairment in COPD patients living at high altitude"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0768-1972","authenticated-orcid":false,"given":"Mauricio","family":"Gonz\u00e1lez-Garc\u00eda","sequence":"first","affiliation":[{"name":"CINEUMO, Fundaci\u00f3n Neumol\u00f3gica Colombiana"},{"name":"Universidad de la Sabana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4360-9604","authenticated-orcid":false,"given":"Nadia Juliana","family":"Proa\u00f1os","sequence":"additional","affiliation":[{"name":"CINEUMO, Fundaci\u00f3n Neumol\u00f3gica Colombiana"},{"name":"Universidad de la Sabana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4700-9822","authenticated-orcid":false,"given":"Alejandro","family":"Casas-Herrera","sequence":"additional","affiliation":[{"name":"CINEUMO, Fundaci\u00f3n Neumol\u00f3gica Colombiana"},{"name":"Universidad de la Sabana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2153-0492","authenticated-orcid":false,"given":"Abraham","family":"Al\u00ed-Munive","sequence":"additional","affiliation":[{"name":"CINEUMO, Fundaci\u00f3n Neumol\u00f3gica Colombiana"},{"name":"Universidad de la Sabana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9001-0613","authenticated-orcid":false,"given":"Carlos Eduardo","family":"Aguirre-Franco","sequence":"additional","affiliation":[{"name":"CINEUMO, Fundaci\u00f3n Neumol\u00f3gica Colombiana"},{"name":"Universidad de la Sabana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0004-8955","authenticated-orcid":false,"given":"Carlos Arturo","family":"Torres-Duque","sequence":"additional","affiliation":[{"name":"CINEUMO, Fundaci\u00f3n Neumol\u00f3gica Colombiana"},{"name":"Universidad de la Sabana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"2024. Tracking SDG 7: The Energy Progress Report","author":"IEA I, UNSD, World Bank, WHO. IEA, IRENA, UNSD, World Bank, WHO","year":"2025","unstructured":"IEA I, UNSD, World Bank, WHO. IEA, IRENA, UNSD, World Bank, WHO. 2024. Tracking SDG 7: The Energy Progress Report. World Bank, 2025. Available from. https:\/\/trackingsdg7.esmap.org\/downloads"},{"key":"e_1_3_3_3_2","unstructured":"(IRENA) REA. Household air pollution 2025. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/household-air-pollution-and-health"},{"key":"e_1_3_3_4_2","first-page":"100746","article-title":"The 2023 Latin America report of the Lancet Countdown on health and climate change: the imperative for health-centred climate-resilient development","volume":"33","author":"Hartinger SM","year":"2024","unstructured":"Hartinger SM, Palmeiro-Silva YK, Llerena-Cayo C, et al. The 2023 Latin America report of the Lancet Countdown on health and climate change: the imperative for health-centred climate-resilient development. Lancet Reg Health Am 2024; 33: 100746. https:\/\/doi.org\/10.1016\/j.lana.2024.100746","journal-title":"Lancet Reg Health Am"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/phn.13524"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1515\/reveh-2023-0158"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2023.107803"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12940-021-00706-1"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1444421"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2021.106593"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2020.142460"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201405-187OC"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2017.06.006"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59040732"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/14799731231163874"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbr.2016.06.026"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.668144"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-1361"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.5588\/ijtldopen.24.0004"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00016-2016"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00010-2017"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00150314"},{"issue":"2","key":"e_1_3_3_26_2","first-page":"103","article-title":"Valores normales de la prueba de marcha de seis minutos (P6M) en adultos sanos mayores de 18 a\u00f1os en Bogot\u00e1, Colombia","volume":"50","author":"Casas A","year":"2014","unstructured":"Casas A, Aguiar P, Gomez V, et al. Valores normales de la prueba de marcha de seis minutos (P6M) en adultos sanos mayores de 18 a\u00f1os en Bogot\u00e1, Colombia. Arch Bronconeumol 2014; 50(Suppl E2): 103.","journal-title":"Arch Bronconeumol"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"e_1_3_3_28_2","first-page":"767","article-title":"Re-validation of the Mini-Examen Cognoscitivo (first Spanish version of the Mini-Mental Status Examination) in the elderly people","volume":"112","author":"Lobo A","year":"1999","unstructured":"Lobo A, Saz P, Marcos G, et al. Re-validation of the Mini-Examen Cognoscitivo (first Spanish version of the Mini-Mental Status Examination) in the elderly people. Medicina cl\u00ednica 1999; 112: 767\u2013774.","journal-title":"Medicina cl\u00ednica"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2023-001709"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-024-03403-0"},{"key":"e_1_3_3_31_2","first-page":"199","article-title":"Hypoxemia in patients with COPD: cause, effects, and disease progression","volume":"6","author":"Kent BD","year":"2011","unstructured":"Kent BD, Mitchell PD, McNicholas WT. Hypoxemia in patients with COPD: cause, effects, and disease progression. Int J Chron Obstruct Pulmon Dis 2011; 6: 199\u2013208. https:\/\/doi.org\/10.2147\/COPD.S10611","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"e_1_3_3_32_2","first-page":"263","article-title":"COPD and cognitive impairment: the role of hypoxemia and oxygen therapy","volume":"5","author":"Thakur N","year":"2010","unstructured":"Thakur N, Blanc PD, Julian LJ, et al. COPD and cognitive impairment: the role of hypoxemia and oxygen therapy. Int J Chron Obstruct Pulmon Dis 2010; 5: 263\u2013269. https:\/\/doi.org\/10.2147\/copd.s10684","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000009599"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-015-0116-3"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/2516865720954873"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.09.103"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-024-01286-5"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2019.01.012"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.155394"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2022.113265"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.3390\/atmos13040509"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(26)00002-1"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2018.08.381"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.5505\/ejm.2020.25428"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12989-020-0337-x"}],"container-title":["Chronic Respiratory Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14799731261462164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14799731261462164","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14799731261462164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T08:16:27Z","timestamp":1781856987000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14799731261462164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":44,"alternative-id":["10.1177\/14799731261462164"],"URL":"https:\/\/doi.org\/10.1177\/14799731261462164","relation":{},"ISSN":["1479-9731","1479-9731"],"issn-type":[{"value":"1479-9731","type":"print"},{"value":"1479-9731","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"article-number":"14799731261462164"}}