Chest
Original Research: COPDDrawing Impairment Predicts Mortality in Severe COPD
Section snippets
Materials and Methods
From October 2000 to May 2002, we consecutively enrolled 149 COPD patients who had undergone a period 40 to 60 days of in-hospital rehabilitation following an acute exacerbation of COPD. At the time of data collection, participants were in stable condition, and their Pao2, Paco2, and personal independence were comparable to those reported before the exacerbation in the ambulatory records. The diagnosis of COPD was made according to American Thoracic Society standards.9 Only patients with a Pao2
Results
We had follow-up information for 134 of 149 participants (90% of the baseline cohort). Patients who were lost to follow-up and those who were successfully tracked had comparable respiratory function test results, clinical/neuropsychological characteristics, and performance status, but patients lost to follow-up were older (mean age, 74.2 ± 5.1 vs 69.0 ± 8.6 years, respectively; F = 3.746 [by analysis of variance]; p = 0.057). Over a cumulative observation period of 4,362 months, 29 participants
Discussion
We found that in patients with severe COPD two nonrespiratory indexes of health status (ie, a low score on the copying of a drawing with landmark test and a low 6MWD) predict mortality. The effect of neuropsychological dysfunction on mortality was independent of arterial hypoxemia, a nearly significant predictor, and the two factors showed only a weak synergy, indicating that the increase in risk in people with both factors is roughly equal to the sum of the risks associated with each of them.
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2021, Respiratory MedicineCitation Excerpt :Evidence suggests that chronic hypoxemia in COPD patients is a likely mechanism for hippocampal atrophy, which plays a key role in cognitive impairment [53,54]. From a clinical perspective, this evidence-based hypothesis [53,54] is important but usually not tested in the typical clinical settings. Moreover, hypoxemic-hypercapnic COPD has been suggested as an original model of cognitive decline [55].
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2019, Brain ResearchCitation Excerpt :Respiratory diseases such as COPD are associated with multiple comorbidities that present major health risks such as Heart Disease, Osteoporosis, Type 2 Diabetes, Hypertension, Lung Cancer, and cognitive impairment (Antonelli-Incalzi et al., 2006; Chatila et al., 2008; Incalzi et al., 1997; Incalzi et al., 1993). Of these comorbidities, cognitive impairment has been shown to be prevalent in as many as 33% of patients with COPD (Antonelli-Incalzi et al., 2006; Torres-Sanchez et al., 2015), indicating COPD as a major risk factor for the development of cognitive impairment. The specific aspects of cognition affected by COPD vary across studies, however the data suggest that the effects of COPD on cognition are not limited to any single cognitive function, and span across multiple cognitive domains including perception, attention, memory and learning, executive function, language, general intelligence, and social cognition (Torres-Sanchez et al., 2015).
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2019, European Journal of PharmacologyCitation Excerpt :In a systematic review covering literature till 2010 from Schou and colleagues, a significant impairment in cognitive performance of COPD patients was found compared to healthy controls in 8 of the 14 case control studies (Schou et al., 2012). The prevalence of cognitive dysfunction in COPD patients is determined in multiple studies being between 17% and 56.7%, compared to 12–16.7% in healthy controls (Antonelli-Incalzi et al., 2006; Cleutjens et al., 2017a; Incalzi et al., 1993; Martinez et al., 2014; Ouellette and Lavoie, 2017; Roncero et al., 2016; Yohannes et al., 2017). Verbal memory, attention, processing speed, coordination and learning ability are shown to be the most influenced cognitive functions in COPD (Schou et al., 2012).
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
All authors have no conflict of interest in the subject matter of the manuscript.
This study was supported by a grant from the Italian Ministry of Health (Conv. N. ICS 030.8/RF99.42).