Cognitive Functions in Patients with Chronic Obstructive Pulmonary Disease: A Cross Sectional study

Vimal, T (2020) Cognitive Functions in Patients with Chronic Obstructive Pulmonary Disease: A Cross Sectional study. Masters thesis, Coimbatore Medical College, Coimbatore.


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BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of death mainly due to the habit of smoking. Although it is primarily a respiratory disease, the ensuing hypoxemia in untreated or non compliant cases lead to a variety of systemic manifestations thereby considering COPD as a multi organ systemic illness. Among the various systems affected, cognitive deficit is gaining importance as it can impair day to day normal functioning at a very early age. It can interfere with driving, remembering day to day task and above all, it can also become a cause for non compliance to treatment thereby exaggerating the illness. AIM OF THE STUDY: The aim of this study is to assess the various domains of cognition like attention, memory, language, fluency, visuo spatial ability and executive functions in patients with COPD. MATERIALS AND METHODS: 120 COPD patients were recruited from the thoracic medicine OPD and 120 healthy individuals were recruited from general population as controls. The COPD patients were subject to Pulmonary Function Test (PFT) using a spirometry and were categorised into one of the Global initiative for Obstructive Lung Diseases (GOLD) category. Both cases and controls were administered the Addenbrooke’s Cognitive Examination III (ACE III), Montreal Cognitive Assessment (MoCA) and Trail. Making Tests part A & B (TMT-A & B). The scores were compared among the groups by independent ‘t’ test and correlation of PFT parameters with the cognitive scores was done by Pearson’s Correlation. RESULTS: The mean ACE III score among the cases was 76.99 ± 8.58 and among the controls was 94.31 ± 2.191 which was statistically significant (p < 0.001). The mean MoCA score was 22.51 ± 2.76 and 27.65 ± 0.98 among cases and controls respectively which was also statistically significant. All the five domains in ACE III viz., attention, memory, language, frequency and visuo spatial ability were significantly affected among the COPD patients. The scores of the above domains and the total ACE III and MoCA scores were more affected in grade IV individuals. The TMT A & B scores were also significantly affected in cases group. TMT-A [Cases (64.20 ± 24.496), Controls (37.50 ± 7.451)] and TMT-B [Cases (150.82 ± 28.678), Controls (70.83 ± 11.420)]. The PFT parameters namely, Forced Expiratory Volume at first second (FEV1) (r=0.333 and p <0.001) and FEV1 / FVC ratio(r=0.360 and p <0.001) correlated positively with ACE III score which were significant. CONCLUSION: The results of this study suggest that there is a significant cognitive decline in patients with COPD especially with respect to attention and memory domains. Earlier screening for cognitive dysfunction and appropriate management along with pulmonary rehabilitation can make the quality of patient’s life better and self dependent.

Item Type: Thesis (Masters)
Additional Information: 201715254
Uncontrolled Keywords: Chronic Obstructive Pulmonary Disease, Cognition, Addenbrooke’s Cognitive Examination, Montreal Cognitive Assessment, Trail Making Tests, Hypoxemia, Mild Cognitive Impairment, Dementia, Alzheimer’s Disease, Emphysema, Pulmonary Function Test, Clock Drawing Test.
Subjects: MEDICAL > Physiology
Depositing User: Subramani R
Date Deposited: 30 Jan 2021 17:07
Last Modified: 01 Mar 2021 02:45

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