The association of cognitive functioning as measured by the DemTect with functional and clinical characteristics of COPD: results from the COSYCONET cohort

被引：16

作者：

von Siemens, Sarah Marietta ^{[1
]}

Perneczky, Robert ^{[2
,3
,4
,5
]}

Vogelmeier, Claus F. ^{[6
,7
]}

Behr, Juergen ^{[8
,9
,10
,22
]}

Kauffmann-Guerrero, Diego ^{[8
,9
]}

Alter, Peter ^{[6
,7
]}

Trudzinski, Franziska C. ^{[11
]}

Bals, Robert ^{[11
,21
]}

Grohe, Christian ^{[12
,28
]}

Soehler, Sandra ^{[13
]}

Waschki, Benjamin ^{[14
,15
,16
]}

Lutter, Johanna, I ^{[17
,18
]}

Welte, Tobias ^{[19
]}

Joerres, Rudolf A. ^{[1
]}

Kahnert, Kathrin ^{[8
,9
,22
]}

Andreas, Stefan ^{[20
]}

Bewig, Burkhard ^{[23
]}

Buhl, Roland ^{[24
]}

Ewert, Ralf ^{[25
]}

Ficker, Joachim H. ^{[26
]}

Stubbe, Beate ^{[25
]}

Gogol, Manfred ^{[27
]}

Hauck, Rainer ^{[29
]}

Held, Matthias ^{[30
]}

Jany, Berthold ^{[30
]}

Henke, Markus ^{[10
]}

Herth, Felix ^{[31
]}

Hoeffken, Gerd ^{[32
]}

Katus, Hugo A. ^{[33
]}

Kirsten, Anne-Marie ^{[34
]}

Watz, Henrik ^{[34
]}

Koczulla, Rembert ^{[35
]}

Kenn, Klaus ^{[35
]}

Kronsbein, Juliane ^{[36
]}

Kropf-Sanchen, Cornelia ^{[37
]}

Lange, Christoph ^{[38
]}

Zabel, Peter ^{[38
]}

Pfeifer, Michael ^{[39
]}

Randerath, Winfried J. ^{[40
]}

Seeger, Werner ^{[41
]}

Studnicka, Michael ^{[42
]}

Taube, Christian ^{[43
]}

Teschler, Helmut ^{[43
]}

Timmermann, Hartmut ^{[44
]}

Virchow, J. Christian ^{[45
]}

Vogelmeier, Claus ^{[46
]}

Wagner, Ulrich ^{[47
]}

Welte Tobias ^{[48
]}

Wirtz, Hubert ^{[49
]}

机构：

[1] Ludwig Maximilians Univ Munchen, CPC M, Inst & Outpatient Clin Occupat Social & Environm, Ziemssenstr 1, D-80336 Munich, Germany

[2] Ludwig Maximilians Univ Munchen, Dept Psychiat & Psychotherapy, Univ Hosp, Munich, Germany

[3] German Ctr Neurodegenerat Disorders DZNE Munich, Munich, Germany

[4] Munich Cluster Syst Neurol SyNergy, Munich, Germany

[5] Imperial Coll London, Sch Publ Hlth, Ageing Epidemiol Res Unit AGE, London, England

[6] Philipps Univ Marburg, Univ Med Ctr Giessen & Marburg, Dept Med Pulm & Crit Care Med, Baldingerstr, D-35043 Marburg, Germany

[7] German Ctr Lung Res DZL, Baldingerstr, D-35043 Marburg, Germany

[8] Univ Munich LMU, Comprehens Pneumol Ctr, Dept Internal Med 5, Ziemssenstr 1, D-80336 Munich, Germany

[9] German Ctr Lung Res, Ziemssenstr 1, D-80336 Munich, Germany

[10] Asklepios Fachkliniken Munchen Gauting, Robert Koch Allee 2, D-82131 Gauting, Germany

[11] Saarland Univ Hosp, Dept Internal Med Pulmonol Allergol Resp Intens C, Kirrberger Str 1, D-66424 Homburg, Germany

[12] Evangel Lungenklin, Lindenberger Weg 27, D-13125 Berlin, Germany

[13] Univ Marburg, ASCONET Study Coordinat Off, Baldingerstr, D-35043 Marburg, Germany

[14] Univ Heart Ctr Hamburg, Dept Gen & Intervent Cardiol, Hamburg, Germany

[15] LungenClin Grosshansdorf, ARCN, Grosshansdorf, Germany

[16] German Ctr Lung Res DZL, Grosshansdorf, Germany

[17] Helmholtz Zentrum Munchen GmbH, Inst Hlth Econ & Hlth Care Management, German Res Ctr Environm Hlth, Comprehens Pneumol Ctr Munich, Ingolstadter Landstr 1, D-85764 Munich, Germany

[18] German Ctr Lung Res, Ingolstadter Landstr 1, D-85764 Munich, Germany

[19] Hannover Med Sch, Dept Pneumol, Carl Neuberg Str 1, D-30625 Hannover, Germany

[20] Lungenfachklin, Immenhausen, Germany

[21] Univ Klinikum Saarlandes, Homburg, Germany

[22] Klinikum Ludwig Maximilians Univ Munchen, Munich, Germany

[23] Univ Klinikum Schleswig Holstein, Lubeck, Germany

[24] Johannes Gutenberg Univ Mainz, Univ Med, Mainz, Germany

[25] Univ Med Greifswald, Greifswald, Germany

[26] Paracelsus Med Privatuniv Nurnberg, Klinikum Nurnberg, Nurnberg, Germany

[27] Heidelberg Univ, Inst Gerontol, Heidelberg, Germany

[28] Ev Lungenklin, Berlin, Germany

[29] Kliniken Sudostbayern AG, Kreisklin Bad Reichenhall, Bad Reichenhall, Germany

[30] Klinikum Wurzburg Mitte gGmbH, Standort Missioklin, Wurzburg, Germany

[31] Thoraxklin Heidelberg gGmbH, Heidelberg, Germany

[32] Fachkrankenhaus Coswig GmbH, Coswig, Germany

[33] Univ Klinikum Heidelberg, Heidelberg, Germany

[34] Lungenclin Grosshansdorf GmbH, Pneumol Forschungsinst, Grosshansdorf, Germany

[35] Schon Klin Berchtesgadener Land, Schonau, Germany

[36] Berufsgenossenschaftliches Univ Klinikum Bergmann, Bochum, Germany

[37] Univ Klinikum Ulm, Ulm, Germany

[38] Forschungszentrum Borstel, Sulfeld, Germany

[39] Klin Donaustauf, Donaustauf, Germany

[40] Wissensch Liches Inst Bethanien eV, Solingen, Germany

[41] Justus Liebig Univ Giessen, Giessen, Germany

[42] Uniklinikum Salzburg, Salzburg, Austria

[43] Ruhrlandklin gGmbH Essen, Essen, Germany

[44] Hamburger Inst Therapieforsch GmbH, Hamburg, Germany

[45] Univ Klinikum Rostock, Rostock, Germany

[46] Univ Klinikum Giessen & Marburg GmbH, Marburg, Germany

[47] Klin Lowenstein gGmbH, Lowenstein, Germany

[48] Hannover Med Sch, Hannover, Germany

[49] Univ Klinikum Leipzig, Leipzig, Germany

来源：

RESPIRATORY RESEARCH | 2019年 / 20卷 / 01期

关键词：

COPD; Dementia; Cognitive impairment; OBSTRUCTIVE PULMONARY-DISEASE; LUNG-FUNCTION; SCREENING TOOL; IMPAIRMENT; RISK; DECLINE; DEMENTIA; COMORBIDITIES; METAANALYSIS; DYSFUNCTION;

D O I：

10.1186/s12931-019-1217-5

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Alterations of cognitive functions have been described in COPD. Our study aimed to disentangle the relationship between the degree of cognitive function and COPD characteristics including quality of life (QoL). Data from 1969 COPD patients of the COSYCONET cohort (GOLD grades 1-4; 1216 male/ 753 female; mean (SD) age 64.9 +/- 8.4 years) were analysed using regression and path analysis. The DemTect screening tool was used to measure cognitive function, and the St. George's respiratory questionnaire (SGRQ) to assess disease-specific QoL. DemTect scores were < 9 points in 1.6% of patients and < 13 points in 12% when using the original evaluation algorithm distinguishing between < 60 or > =60 years of age. For statistical reasons, we used the average of both algorithms independent of age in all subsequent analyses. The DemTect scores were associated with oxygen content, 6-min-walking distance (6-MWD), C-reactive protein (CRP), modified Medical Research Council dyspnoea scale (mMRC) and the SGRQ impact score. Conversely, the SGRQ impact score was independently associated with 6-MWD, FVC, mMRC and DemTect. These results were combined into a path analysis model to account for direct and indirect effects. The DemTect score had a small, but independent impact on QoL, irrespective of the inclusion of COPD-specific influencing factors or a diagnosis of cognitive impairment. We conclude that in patients with stable COPD lower oxygen content of blood as a measure of peripheral oxygen supply, lower exercise capacity in terms of 6-MWD, and higher CRP levels were associated with reduced cognitive capacity. Furthermore, a reduction in cognitive capacity was associated with reduced disease-specific quality of life. As a potential clinical implication of this work, we suggest to screen especially patients with low oxygen content and low 6-MWD for cognitive impairment.

引用

页数：13

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