Changes in Cognitive Status in COPD Patients Across Clinical Stages

Chronic obstructive pulmonary disease (COPD) is a progressive disease, its prevalence increases with age. COPD is frequently associated with co-morbidities such as cognitive impairment, and their clinical relevance has risen in the recent past. Cognitive function may fluctuate with the variable components of COPD like hypoxaemia, hypercapnia, lung function, exacerbations or severity of the disease. The objectives of this study were to examine whether the cognitive status of COPD patients is different across clinical stages (exacerbation, at discharge and stable COPD) and also if there are cognitive areas that have more potential to change than others. Prospective observational clinical study: 62 patients admitted to hospital due to acute exacerbation of COPD were evaluated at hospital admission; 61 at discharge; and finally, 48 patients with stable COPD completed the study and were included in the analysis. Cognitive status was assessed with the Montreal Cognitive Assessment (MoCA). Our results show that all clinical variables improved from exacerbation to discharge COPD. MoCA total score, visuoconstructional, attention, language, abstraction, delayed recall and orientation subscores improved significantly from exacerbation to discharge COPD (p < 0.05). MoCA total score, visuoconstructional and naming subscores worsened significantly from discharge to stable COPD (p<0.05). Finally, from exacerbation to stable COPD all the clinical variables improved; MoCA total score and naming, attention, language, abstraction and delayed recall subscores have shown significant differences (p<0.05). Cognitive status of COPD patients is different across clinical stages, and there are cognitive areas with more potential to change than others.