Cognitive impairment in chronic obstructive pulmonary disease.

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. Our study aim was to evaluate the impact of stable COPD and exacerbation (AECOPD) phases on cognitive status using MoCA questionnaire.We enrolled 39 patients (pts), smokers with COPD group D (30 stable and 9 in AECOPD) and 13 healthy subjects (control group), having similar level of education and no significant differences regarding the anthropometric measurements. We analyzed the differences in MoCA score between these three groups and also the correlation between this score and inflammatory markers.Patients with AECOPD had a significant (p<0.001) decreased MoCA score (14.6±3.4) compared to stable COPD (20.2±2.4) and controls (24.2±5.8). The differences between groups were more accentuated for the language abstraction and attention (p<0.001) and delayed recall and orientation (p<0.001) sub-topics. No significant variance of score was observed between groups regarding visuospatial and naming score (p = 0.095). The MoCA score was significantly correlated with forced expiratory volume (r = 0.28) and reverse correlated with C-reactive protein (CRP) (r = -0.57), fibrinogen (r = -0.58), erythrocyte sedimentation rate (ESR) (r = -0.55) and with the partial pressure of CO2 (r = -0.47).According to this study, COPD significantly decreases the cognitive status in advanced and acute stages of the disease

Comparison of patients parameters between studied groups.

a<p>Variables are Gaussian distributed. Results are presented as mean ± standard deviation. p values were calculated with unpaired t-student and ANOVA tests.</p>b<p>Variables are not-Gaussian distributed. Results are presented as median and interquartile range. p values were calculated using Kruskal-Wallis and Mann-Whitney U tests.</p><p>CRP – C-reactive protein, RBC – Red blood cell, WBC – White blood cell, FVC – Force vital capacity, FEV₁ – Forced expiratory volume.</p

Multivariate regression analysis between studied parameters and MoCA score.

<p>Multivariate regression analysis between studied parameters and MoCA score.</p

Correlation between MOCA score and clinical parameters.

<p>Correlation between MOCA score and clinical parameters.</p

BoxPlot for MoCA score in the three study subgroups.

<p>The band inside the box represents the median score; the top and bottom of the box the third respectively the first quartile; the whiskers - data within 1.5 interquartile range and stars and circles the outliers.</p