Chest
Original ResearchCOPDMild Cognitive Impairment in Moderate to Severe COPD: A Preliminary Study
Section snippets
Patient Selection
Patients with COPD were prospectively enrolled and referred by a pneumologist from the outpatient COPD clinic at the Hôpital du Sacré-Coeur de Montréal. The inclusion criteria were: (1) clinically stable moderate to severe COPD according to the GOLD (Global Initiative for Chronic Obstructive Lung Disease) classification,15 (2) postbronchodilation FEV1 < 80% of the predicted normal value and FEV1 to FVC ratio < 0.7, (3) age ≥ 40 years, and (4) smoking history of ≥ 10 American pack-years (20
Results
Of the 53 patients with COPD invited to participate in the study, eight were excluded (five refused, one for concomitant schizophrenia, one for alcoholism, and one for native language other than French or English), for a final sample of 45 patients with COPD (Table 2 for sociodemographic and clinical characteristics). No significant differences were found between patients with COPD and control subjects for age, sex, educational level, or excessive daytime sleepiness (Epworth Sleepiness Scale
Discussion
The main finding of this study was that patients with moderate to severe COPD are at high risk for MCI, with an estimated 36% frequency. This is significantly higher than the proportion of MCI found in healthy control subjects matched for age, sex, education, and severity of excessive daytime sleepiness. Moreover, we found convincing evidence that the MoCA is a more reliable screening test than the MMSE in detecting MCI in patients with COPD.
Acknowledgments
Author contributions: Drs Villeneuve, Pepin, and Gagnon are guarantors of the article.
Dr Villeneuve: contributed to data acquisition, analysis, and interpretation; wrote the first draft of the manuscript; and revised it following critical reviews by the coauthors.
Dr Pepin: contributed to study design, data acquisition and interpretation, study coordination, and fundraising and critically reviewed the manuscript.
Mr Rahayel: contributed to data acquisition and analysis and critically reviewed the
References (50)
- et al.
Burden and clinical features of chronic obstructive pulmonary disease (COPD)
Lancet
(2004) - et al.
Construct validity of activities of daily living scale: a clue to distinguish the disabling effects of COPD and congestive heart failure
Chest
(2005) - et al.
Mild cognitive impairment
Lancet
(2006) - et al.
The nature of episodic memory deficits in MCI with and without vascular burden
Neuropsychologia
(2011) - et al.
“Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician
J Psychiatr Res
(1975) Trail Making Test A and B: normative data stratified by age and education
Arch Clin Neuropsychol
(2004)- et al.
Normative data stratified by age and education for two measures of verbal fluency: FAS and animal naming
Arch Clin Neuropsychol
(1999) - et al.
The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease
Alzheimers Dement
(2011) - et al.
Amnestic MCI or prodromal Alzheimer's disease?
Lancet Neurol
(2004) - et al.
Cognitive activity, education and socioeconomic status as preventive factors for MCI and Alzheimer's disease
Psychiatry Res
(2012)
Cognitive reserve
Neuropsychologia
Cognitive reserve and the neurobiology of cognitive aging
Ageing Res Rev
Global burden of COPD: systematic review and meta-analysis
Eur Respir J
Cognitive function in COPD
Eur Respir J
Drawing impairment predicts mortality in severe COPD
Chest
Mild cognitive impairment as a clinical entity and treatment target
Arch Neurol
Vascular risk factors, incidence of MCI, and rates of progression to dementia
Neurology
Detection of mild cognitive impairment using cognitive screening tests: a critical review and preliminary data on the Mattis Dementia Rating Scale
The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment
J Am Geriatr Soc
The MoCA: well-suited screen for cognitive impairment in Parkinson disease
Neurology
The Montreal Cognitive Assessment: a screening tool for mild cognitive impairment in REM sleep behavior disorder
Mov Disord
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary
Am J Respir Crit Care Med
DSM-IV-TR
Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Revision
Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease
Am J Respir Crit Care Med
Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal
Eur Respir J Suppl
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Funding/Support: This study was supported by grants from the Fonds de recherche du Québec-Santé (Drs Pepin and Gagnon), the Canadian Lung Association/Canadian Respiratory Health Professionals (Dr Pepin), the Faculté des sciences humaines de l'Université du Québec à Montréal (Dr Gagnon), and the Réseau provincial de recherche en adaptation-réadaptation (scholarship to Mr Rahayel).
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