Mild cognitive impairment in moderate to severe COPD: a preliminary study.
BACKGROUND
Cognitive impairment is a frequent feature of COPD. However, the proportion of patients with COPD with mild cognitive impairment (MCI) is still unknown, and no screening test has been validated to date for detecting MCI in this population. The goal of this study was to determine the frequency and subtypes of MCI in patients with COPD and to assess the validity of two cognitive screening tests, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), in detecting MCI in patients with COPD.


METHODS
Forty-five patients with moderate to severe COPD and 50 healthy control subjects underwent a comprehensive neuropsychologic assessment using standard MCI criteria. Receiver operating characteristic curves were obtained to assess the validity of the MMSE and the MoCA to detect MCI in patients with COPD.


RESULTS
MCI was found in 36% of patients with COPD compared with 12% of healthy subjects. Patients with COPD with MCI had mainly the nonamnestic MCI single domain subtype with predominant attention and executive dysfunctions. The optimal MoCA screening cutoff was 26 (≤ 25 indicates impairment, with 81% sensitivity, 72% specificity, and 76% correctly diagnosed). No MMSE cutoff had acceptable validity.


CONCLUSIONS
In this preliminary study, a substantial proportion of patients with COPD were found to have MCI, a known risk factor for dementia. Longitudinal follow-up on these patients is needed to determine the risk of developing more severe cognitive and functional impairments. Moreover, the MoCA is superior to the MMSE in detecting MCI in patients with COPD.
Département de Psychologie, Université de Montréal, Montreal, QC; Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC; Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Montreal, QC.
Sylvia
S
Villeneuve
Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Montreal, QC; Department of Exercise Science, Concordia University, Montreal, QC.
Véronique
V
Pepin
Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Montreal, QC; Département de Psychologie, Université du Québec à Montréal, Montreal, QC.
Shady
S
Rahayel
Département de Psychologie, Université de Montréal, Montreal, QC; Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Montreal, QC.
Josie-Anne
JA
Bertrand
Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Montreal, QC.
Myriam
M
de Lorimier
Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Montreal, QC; Department of Exercise Science, Concordia University, Montreal, QC.
Amanda
A
Rizk
Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Montreal, QC.
Catherine
C
Desjardins
Service de Pneumologie, Hôpital du Sacré-Coeur de Montréal, Montreal, QC.
Simon
S
Parenteau
Service de Pneumologie, Hôpital du Sacré-Coeur de Montréal, Montreal, QC.
François
F
Beaucage
Geriatric Rehabilitation Service, Bruyère Continuing Care, Ottawa, ON, Canada.
Steve
S
Joncas
Département de Radiologie, Université de Montréal, Montreal, QC; Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC.
Oury
O
Monchi
Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Montreal, QC; Département de Psychologie, Université du Québec à Montréal, Montreal, QC. Electronic address: gagnon.jean-francois.2@uqam.ca.
Jean-François
JF
Gagnon
D000368:Aged; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000523:psychology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index