title: Extent and prevalence of cognitive dysfunction in chronic obstructive pulmonary disease, chronic non-obstructive bronchitis, and in asymptomatic smokers, compared to normal reference values.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) can affect cognition. The effects of other less severe chronic airway disorders on cognition remain to be clarified. This study aimed to measure and compare cognitive deterioration in subjects with COPD, subjects with chronic non-obstructive bronchitis (CNOB), and asymptomatic smokers (AS), and to relate the corresponding prevalence to several demographic and clinical variables and to normal reference values.
  
  
  METHODS
  Four hundred and two subjects (COPD n=229, CNOB n=127, and AS n=46) of comparable age were included in the study. Cognitive impairment was assessed using the Mini Mental Status test, the Clock Drawing test, and the Trail Making test A and B.
  
  
  RESULTS
  The extent and prevalence of cognitive deterioration was greater in COPD subjects, followed by CNOB subjects and AS (P<0.001). The Medical Research Council and COPD Assessment test scores, forced expiratory volume in the first second predicted, and arterial partial pressure of O2 and of CO2 were related to the extent and the prevalence of cognitive deterioration. COPD subjects, CNOB subjects, and AS aged 40-69 years showed the greatest cognitive impairment (P<0.01 compared to normal values). This was particularly clear in COPD subjects.
  
  
  CONCLUSIONS
  Cognitive impairment may start at the early stages of chronic airway damage and progress with a worsening of the respiratory condition. Indeed, the greatest cognitive deterioration was seen in COPD subjects. Cognition impairment may contribute to explaining the insufficient adherence to therapeutic plans and strategies, and the increasing social costs in respiratory subjects.
authors: National Center for Respiratory Pharmacoeconomics and Pharmacoepidemiology (CESFAR), Verona, Italy.
authors: Roberto W
authors: RW
authors: Dal Negro
authors: National Center for Respiratory Pharmacoeconomics and Pharmacoepidemiology (CESFAR), Verona, Italy.
authors: Luca
authors: L
authors: Bonadiman
authors: Lung Division, Bussolengo General Hospital, Bussolengo, Italy.
authors: Silvia
authors: S
authors: Tognella
authors: Research and Clinical Governance, Verona, Italy.
authors: Fernanda P
authors: FP
authors: Bricolo
authors: Research and Clinical Governance, Verona, Italy.
authors: Paola
authors: P
authors: Turco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001991:Bronchitis / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D013147:Spirometry; D014145:Trail Making Test
keywords: COPD; chronic airway flow limitation; chronic bronchitis; cognition; smoke