Abstract
Background/Purpose. Chronic obstructive pulmonary disease (COPD), especially in severe forms, is commonly associated with multiple cognitive problems. Montreal Cognitive Assessment test (MoCA) is used to detect cognitive impairment evaluating several areas: visuospatial, memory, attention and fluency. We followed the impact of acute and stable COPD phases on cognition status using MoCA questionnaire.
Methods. 38 patients (pts.) smokers, COPD group D (28 stable and 10 acute exacerbation AECOPD) and 10 healthy subjects (control group, CG) having the same level of education and anthropometric data performed spirometry, MoCA questionnaire; blood gases and inflammatory markers were collected.
Results. In the MoCA test (total score) AECOPD patients showed a significant lower score (means cognitive alteration) than patients in stable phase and in the control group (15±2,64 AECOPD vs. 20,07±2,39 COPD vs. 26,2±1,03 CG, p<0,0001). Major differences were recorded at attention (0,15 AECOPD vs. 0,375 COPD vs. 0,9 CG, p=0,0003) and visuospatial/executive (15 ±2,64 AECOPD vs. 20,07 ±2,39 COPD vs. 27,2 ±1,03 CG, p=0,0002). Beside the boundry blood gases, we found a moderate correlation between MoCA and inflammatory markers (r=-0.492 p= 0.034 for fibrinogen, respectively r=-0.461, p= 0.048 for CRP).
Conclusions. According to this questionnaire, COPD significantly decreases the cognitive status in advanced and acute stages of the disease. Although hypoxemia is recognized as a factor that alters the cognition, the present study advances the idea that in addition to hypoxemia the inflammatory factors might play an important role.
- © 2014 ERS