Mild to moderate chronic airways disease does not carry an excess risk of cognitive dysfunction.
OBJECTIVE
Whether chronic obstructive pulmonary disease (COPD) carries a risk of cognitive dysfunction prior to the onset of arterial hypoxemia is not known. Our objective was to assess both the prevalence and main correlates of subclinical cognitive dysfunction in older patients with non-hypoxemic COPD.


METHODS
Home-dwelling non-demented subjects over 64 years of age consecutively attending 24 outpatient Departments of Respiratory Medicine or Geriatrics because of COPD (N = 233), asthma (N = 203), non-obstructive bronchitis (N = 92) or chronic non-respiratory and non-dementing diseases (controls, N = 1080) underwent a multidimensional assessment. Cognitive status was assessed by the Mini-Mental State Examination (MMSE). Independent correlates of MMSE < 24 were identified by logistic regression analysis. In order to limit the confounding effect of collinearity between COPD group membership and the 6' walked distance, a properly designed multivariate analysis was performed.


RESULTS
Prevalence of MMSE < 24 ranged from 16.7% (controls) to 21.9% (COPD). Education < 9 years (Odds Ratio = 1.56, Confidence Intervals = 1.22-1.98), a score > 6 on the 15-item Geriatric Depression Scale (OR = 1.37, CI = 1.16-1.62). a 6' walked distance < 242 m (OR = 1.22, CI = 1.02-1.45), a Barthel Index greater than 80 (OR = 1.48, CI = 1.03-2.14) and a Forced Vital Capacity inferior to 80% of the predicted value (OR = 1.17, CI = 1.09-1.38) qualified as independent correlates of MMSE < 24. The multivariate analysis confirmed that groups had comparable MMSE scores.


CONCLUSIONS
Non-hypoxemic COPD did not increase the risk of subclinical cognitive dysfunction in an older population.
Incalzil
Raffaele Antonelli
RA
Institute of Internal Medicine and Geriatrics, Catholic University, Roma, Italy. raffaele_antonelli@rm.unicatt.it
Bellia
Vincenzo
V
Maggi
Stefania
S
Imperiale
Claudio
C
Capparella
Oliviero
O
Catalano
Filippo
F
Carbonin
PierUgo
P
Rengo
Franco
F
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index