Study: Cognitive Dysfunction Linked to Worsening COPD

Patients with chronic obstructive pulmonary disease (COPD) who had exacerbations and regular use of long-term oxygen therapy (LTOT) were more likely to exhibit worsened cognitive function, according to a recent study.

Investigators of the study, which was published in Clinical Respiratory Journal, examined the association between cognitive dysfunction (CD) and COPD during exacerbation, comparing stable patients with COPD and control participants. The investigators also looked at the cognitive function of LTOT-dependent patients and those not receiving LTOT.

A total of 121 individuals aged 40 to 80 years, were included in the study and divided into 3 groups: exacerbation of COPD (COPD-E), stable COPD (COPD-S), and regular user LTOTD-COPD. Each patient answered questions from the Mini Mental State Examination (MMSE), based on the hypothesis that the MMSE could help evaluate the cognitive status of patients with COPD. 

All of the patients in the study were receiving combination medical therapy consisting of long-acting beta agonists, inhaler steroids, and long-acting anticholinergic agents.

According to the results, MMSE scores were lower in the COPD-E group (18.9) than in the COPD-S group (25.7), with no significant difference between those with stable COPD and the control group.

In the COPD-E group, age average was higher, and older age was related to lower MMSE score, compared with those in the stable group or control group. Additionally, the investigators reported that low educational degree appeared to be a predicting factor for CD in the COPD-E group.

Low MMSE was related with decreased FEV1% pO2 and sO2 values, increased pCO2 values, low educational level, and increased comorbidity. Exacerbation rate was higher in the regular-user LTOTD-COPD group than the nonuser group. 

Overall, MMSE scores were low in the COPD-E group and regular-user LTOTD-COPD group, which “is important because MMSE identifies clinically significant CD,” the investigators wrote. They concluded that the findings indicate that clinicians need to look for CD and take CD into account in the management of COPD.

Reference:

1. Çilingir BM, Günbatar H, Çilingir V. Cognitive dysfunction among patients in chronic obstructive pulmonary disease: Effects of exacerbation and long-term oxygen therapy. The Clinical Respiratory Journal. 2020. https://doi.org/10.1111/crj.13250​.