Chronic Obstructive Pulmonary Disease

Biography

Biography: Vasileios Andrianopoulos

Abstract

Introduction:Cognitive impairment (CI) is a prevalent extra-pulmonary manifestation in COPD, which is associated with increased mortality. We assessed the prevalence and the determinants of CI in patients enrolled for Pulmonary Rehabilitation.

Method: 52 COPD patients (aged: 68±8yrs; FEV₁: 45±14%; 40% women) underwent a comprehensive cognitive assessment in the beginning of PR using a detailed neuropsychological testing battery (Image). Patients were assigned to “CI” and “non-CI” groups according to Montreal Cognitive Assessment (MoCA) cutoff score ≤25points. Clinical data including medical history, respiratory function, health/mood status evaluation by Saint-George respiratory questionnaire (SGRQ) and hospital anxiety-depression scale (HADS) were collected. Patients performed six-minute walk test (6MWT) and cycle endurance test (CET) at 75% of peak work rate.

Results: 23 patients (44%) presented evidences of CI (MoCA≤25) with also lower scores in the other cognitive tests (all p <0.001). CI group had worse memory, attention, language/executive, fluency, visuospatial (all p≤0.001) and concentration performance (Stroop test - accuracy: 96.5% vs 89.8%, p<0.001), while was less educated (12.6 ±2.1yrs vs 11.3 ±2.1yrs, p=0.034). CI group had similar FEV₁%, health and mood status (SGRQ, HADS), and exercise capacity (6MWD: 359 ±85m vs 380 ±116m, p=0.48; CET: 616 ±329sec vs 551 ±370sec, p=0.51) but greater oxygen desaturation during the CET (SpO₂nadir: 92.3 ±2.9% vs 89.9 ±3.9%, p=0.014). Certain threshold of SpO₂nadir (≤90%) increased the risk for CI after adjustment for oxygen-use (p=0.026).

Conclusion: CI is highly prevalent in patients with COPD and affects several cognitive domains. It is associated with the years of education and the oxygen desaturation during the CET, however, it seems that is not associated with exercise capacity in COPD patients.