The relationship between cognitive function and arterial partial pressure O 2  in patients with COPD

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Abstract

Background:

The high incidence of cognition disorders in chronic obstructive pulmonary disease (COPD) patients represents a main focus in public health field recently. Thus, we tried to explore relationship between cognitive function and arterial partial pressure O ₂ (PaO ₂) in patients with COPD as assessed by Mini-mental State Examination (MMSE) and/or Montreal Cognitive Assessment (MoCA).

Materials and methods:

Medical and scientific literature databases, such as Web of Science, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database, were searched independently by 2 reviewers until February 2016. Correlation coefficient ( r or r _s) values were obtained from each study, and 95% confidence intervals (CIs) were calculated using STATA12.0 software.

Results:

A total of 2049 studies were produced, and 9 of which were analyzed (714 participants) in the meta-analysis. The pooled r observed medium relationship for all selected studies ( r = 0.405, 95% CI 0.31–0.55), and notable heterogeneity was also tested between studies (χ ² = 17.72, P = .023; I ² = 54.9%). After the sensitivity and subgroup analysis, the heterogeneity significantly decreased. Subgroup analysis showed that MMSE score was stronger correlation between PaO ₂ and cognitive function than MoCA score in the COPD patients. Begg test did not indicate potential risk of publication bias.

Conclusions:

There was a negative correlation between cognitive function and anoxia in patients with COPD, so it may be extremely essential to predict and improve the status of hypoxia in COPD patients.

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Most cited references 24

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Lung disease as a determinant of cognitive decline and dementia

James W Dodd (2015)

Almost 40 million people currently live with dementia but this is estimated to double over the next 20 years; despite this, research identifying modifiable risk factors is scarce. There is increasing evidence that cognitive impairment is more frequent in those with chronic lung disease than those without. Chronic obstructive pulmonary disease affects 210 million people, with cognitive impairment present in 60% of certain populations. Co-morbid cognitive dysfunction also appears to impact on important outcomes such as quality of life, hospitalisation and survival. This review summarises the evidence of an association between cognition, impaired lung function and obstructive lung disease. It goes on to examine the contribution of neuro-imaging to our understanding of the underlying pathophysiology. While the mechanisms of brain pathology and cognitive impairment are likely to be complex and multi-factorial, there is evidence to suggest a key role for occult cerebrovascular damage independent of traditional vascular risk factors, including smoking. Electronic supplementary material The online version of this article (doi:10.1186/s13195-015-0116-3) contains supplementary material, which is available to authorized users.

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Cognitive dysfunction in patients hospitalized with acute exacerbation of COPD.

James W Dodd, Rebecca A Charlton, Martin van den Broek … (2013)

Cognitive impairment is one of the least well-studied COPD comorbidities. It is known to occur in hypoxemic patients, but its presence during acute exacerbation is not established.

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Cognitive decline among patients with chronic obstructive pulmonary disease.

Juan Wisnivesky, Jeffrey Ross, William Hung … (2009)

Prior research has suggested an association between chronic obstructive pulmonary disease (COPD) and the development of cognitive decline; however, these studies have been cross-sectional or small case series. To determine whether COPD increases the risk of cognitive decline among older adults surveyed in a large, population-based longitudinal cohort. We included data from the 1996 to 2002 waves of the Health and Retirement Study, a biennial nationally representative survey. We studied respondents who completed cognitive testing in 1996 and at least one subsequent survey, and excluded those with unknown history of COPD. Clinical history of COPD was based on self-report; severity was categorized based on use of oxygen or disease-related activity limitations. Our primary outcome was cognitive performance, measured using a validated 35-point scale. We examined the effect of COPD on cognition using multivariable mixed linear models accounting for repeated measurements, adjusted for sociodemographic and clinical characteristics. A total of 4,150 adults were included in our study. Among them, 12% reported a history of COPD (29% severe, 71% nonsevere disease). On repeated measurement, mean cognition scores of older adults with both severe and nonsevere COPD were significantly lower when compared with adults without COPD (2.6 points [P < 0.001] and 0.9 points [P < 0.001], respectively). After multivariable adjustment, mean scores of adults with severe COPD remained lower (0.9 point [P < 0.001]), whereas mean score of adults with nonsevere COPD was no longer different (P = 0.39) when compared with adults without COPD. Severe COPD was associated with lower cognitive performance on standardized measurement over time.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: January 2018

Publication date (Electronic): 26 January 2018

Volume: 97

Issue: 4

Electronic Location Identifier: e9599

Affiliations

[a ]The Second Department of Respiratory, Shaanxi Provincial People's Hospital

[b ]Xi’an Medical University, Xi’an, Shaanxi, China.

Author notes

[∗ ]Correspondence: Li Sun, Shaanxi Provincial People's Hospital, Xi’an, Shaanxi, China (e-mail: dyccg@ 123456126.com ).

Article

Publisher ID: MD-D-17-05113 Accession ID: 09599

DOI: 10.1097/MD.0000000000009599

PMC ID: 5794359

PubMed ID: 29369175

SO-VID: 08c4f4fb-2583-486c-8f38-3595a7f9fc0c

License:

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

History

Date received : 16 August 2017

Date revision received : 1 December 2017

Date accepted : 20 December 2017

Custom metadata

OPEN-ACCESS TRUE

Keywords: anoxia,chronic obstructive,cognition disorders,meta-analysis,pulmonary disease

Data availability:

Keywords: anoxia, chronic obstructive, cognition disorders, meta-analysis, pulmonary disease