We have shown that markers of oxidative stress and inflammation (serum amyloid A (SAA) and C-reactive protein (CRP)) are increased in human lungs and blood during an exacerbation of COPD.29, 31 Thus, increased oxidative stress and systemic inflammation in COPD may exacerbate cerebral blood vessel damage, leading to cognitive impairments in COPD. This evidence concerns the gene CRP and Cognitive impairment.