Dodd et al.(19)
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Observational study |
To assess neuropsychological performance in COPD patients hospitalized
after an acute exacerbation and recovery, compared with patients with
stable COPD and with healthy control subjects |
110 participants: |
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- |
In patients hospitalized with an acute COPD exacerbation, impaired
cognitive function is associated with worse health status and longer
length of hospital stay. Cognitive function might not improve with
recovery |
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30 COPD inpatients hospitalized following an exacerbation |
Mean age, 70 ± 11 years; 15 (50%) were female |
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50 outpatients with stable COPD |
Mean age, 69 ± 8 years; 28 (56%) were female |
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30 healthy control subjects |
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Chang et al.(20)
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Cohort study |
To determine the extent to which the co-occurrence of COPD and
cognitive impairment leads to adverse health outcomes in older
adults |
3,093 patients: |
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None |
Patients with COPD and cognitive impairment had the highest rates of
respiratory-related and all-cause hospitalizations and death |
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431 with COPD only |
188 (43.7%) were 65-70 years of age; 210 (48.7%) were female |
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29 with COPD and cognitive impairment |
6 (21.3%) were 65-70 years of age; 10 (34.5%) were female |
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114 with cognitive impairment only |
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2,519 with neither COPD nor cognitive impairment |
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Dodd et al.(21)
|
Observational study |
To evaluate whether there are significant differences between COPD
patients and control subjects, in terms of white matter integrity and
communication between gray matter resting-state networks, and to test the
observed differences related to disease severity, comorbid
cerebrovascular disease, and cognitive dysfunction |
25 non-hypoxemic COPD patients |
Mean age, 67.8 ± 8.1 years; 11 (44%) were female |
None |
In stable, non-hypoxemic COPD, there is reduced white matter integrity
throughout the brain and widespread disturbance in the functional
activation of gray matter, which might contribute to cognitive
dysfunction. White matter microstructural integrity is independent of
smoking and comorbid cerebrovascular disease, but gray matter functional
activation is not. The mechanisms remain unclear but could include
cerebral small vessel disease caused by COPD |
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25 control subjects |
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Villeneuve et al.(10)
|
Observational study |
To determine the frequency and subtypes of MCI in COPD patients and to
assess the validity of two cognitive screening tests (the MMSE and MoCA)
in detecting MCI in COPD patients |
45 patients with moderate-to-severe COPD |
Mean age, 68.84 ± 8.43 years; 29 (64%) were female |
None |
In this preliminary study, a substantial proportion of COPD patients
were found to have MCI. The MoCA was better than was the MMSE at
detecting MCI in COPD patients. |
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50 healthy control subjects |
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Martin et al.(22)
|
Clinical trial |
To determine the effect of hypoxia on cognitive performance in COPD
patients with PaO2 <6.6 kPa |
10 patients with moderate-to-severe COPD |
Mean age, 64 years; 3 (30%) were female |
For a short period of time, patients breathed 21% O2 when
PaO2 was < 6.6 kPa |
Short-term exposure to hypoxia had no adverse effect on cognitive
function |
Pereira et al.(23)
|
Clinical trial |
To evaluate the effect of a multidisciplinary pulmonary rehabilitation
program on cognitive function in COPD patients, adjusting for potential
confounders |
34 patients with moderate-to-severe COPD |
Mean age, 65.2 ± 7 years; 17 (50%) were female |
3-month program of pulmonary rehabilitation |
Even after adjusting for the sociodemographic factors that might affect
cognitive function, the authors found that pulmonary rehabilitation
improved cognitive performance in COPD patients. There were gender- and
age-related differences in cognitive scores that persisted after
rehabilitation |
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18 healthy control subjects |
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Klein et al.(24)
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Cohort study |
To explore the influence of COPD on attentional functions, learning,
and logical thinking |
60 COPD patients |
Mean age, 63.2 ± 9.8 years; 24 (40%) were female |
None |
In COPD patients, there was global impairment in cognitive functions
that was negatively influenced by advancing age and increased in
proportion to the degree of disease severity |
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60 control subjects |
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Thakur et al.(25)
|
Cohort study |
To elucidate the association between COPD and the risk of cognitive
impairment, in comparison with control subjects without COPD |
1,202 COPD patients |
Mean age, 58.2 ± 6.2 years; 691 (57.4%) were female |
None |
COPD is a major risk factor for cognitive impairment. In COPD patients,
hypoxemia is a major contributor to cognitive impairment and regular use
of home oxygen is a protective factor. Health care providers should
consider screening COPD patients for cognitive impairment |
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302 control subjects |
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Antonelli-Incalzi et al.(14)
|
Observational study |
To assess whether certain neuropsychological patterns are associated
with various limitations to physical independence in COPD patients |
149 COPD patients |
112 (75.2%) were over 65 years of age; 14 (9.4%) were female |
None |
Classic indicators of the severity of COPD showed no correlation with
personal autonomy |
Borson et al.(26)
|
Observational study |
To model the relationship between respiratory failure and domains
related to brain function, including low mood, subtly impaired cognition,
systemic inflammation, and structural/neurochemical brain
abnormalities |
9 healthy control subjects |
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None |
COPD is associated with slight decreases in mood and cognition. Severe
COPD is associated with chronic systemic inflammation and subtle
cognitive deficits (on digit symbol coding tasks). Levels of oxygen
desaturation appear to mediate specific changes in brain neurochemistry
and structure that suggest sustained brain damage |
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18 COPD patients, half of whom were oxygen-dependent |
Mean age, 68.5 ± 8.0 years; 11 (64%) were female |
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Orth et al.(27)
|
Observational study |
To analyze driving performance in COPD patients and healthy control
subjects |
17 COPD patients |
Mean age, 55.2 ± 9.3 years |
None |
Compared with healthy control subjects, COPD patients are more likely
to cause a traffic accident. Impaired driving performance in COPD
patients cannot be predicted on the basis of the severity of the
disease |
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10 healthy control subjects |
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Pinto de Lima et al.(28)
|
Observational study |
To test the hypothesis that clinically stable COPD patients without
overt cognitive symptoms can nonetheless have subtle cognitive
impairment |
30 COPD patients |
Mean age, 65 ± 8 years; 10 (33%) were female |
None |
There might be subclinical encephalopathy in COPD, characterized by
subtle impairment of global cognitive ability |
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34 control subjects |
24 (71%) were female |
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Salik et al.(29)
|
Observational study |
To determine the relationship between cognitive function and quality of
life in COPD patients with mild hypoxemia and moderate airway
obstruction |
32 patients with moderate stable COPD |
Mean age, 66.7 ± 2.5 years; 14 (44%) were female |
None |
Cognitive function in COPD patients with hypoxemia might not be
impaired despite their poor quality of life status |
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26 healthy subjects |
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Antonelli-Incalzi et al.(30)
|
Observational study |
To evaluate the prognostic role of cognitive impairment in patients
with severe COPD |
149 COPD patients who had undergone a period of in-hospital
rehabilitation following an acute exacerbation |
Mean age, 68.7 ± 8.5 years; 22 (16.4%) were female |
None |
Impaired drawing ability is a risk factor for mortality and its testing
might improve the assessment of hypoxemic COPD patients |
Corsonello et al.(31)
|
Observational study |
To determine whether cancer is more disabling than are other chronic
diseases that are highly prevalent in the elderly |
6 groups of patients: |
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None |
Cognitive impairment was more prevalent in patients with congestive
heart failure or COPD than in those with cancer |
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Congestive heart failure (n = 832) |
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Diabetes mellitus (n = 939) |
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COPD (n = 399) |
178 (44.6%) were 65-79 years of age; 147 (36.8%) were female |
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Non-metastatic solid tumors (n = 813) |
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Metastatic solid tumors (n = 259) |
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Leukemia/lymphoma (n = 326) |
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Antonelli-Incalzi et al.(32)
|
Observational study |
To determine whether the neuropsychological performance of untreated
patients with OSA conforms to a distinctive pattern |
49 newly diagnosed, untreated OSA patients |
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None |
A minority of newly diagnosed OSA patients had distinct
neuropsychological impairment. The greater body mass index of cognitively
impaired OSA patients indicates that the metabolic syndrome might also be
causally related to the cognitive dysfunction |
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27 patients with multi-infarct dementia |
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31 patients with mild-to-moderate dementia of the Alzheimer type |
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63 patients with severe COPD |
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