Cognitive performance in patients with COPD

Liesker, Jeroen J W; Postma, Dirkje S.; Beukema, Rypko; Hacken, Nick H. T. ten; Molen, Thys van der; Ra, Riemersma; Zomeren, Ed H. van; Kerstjens, Huib A. M.

doi:10.1016/j.rmed.2003.11.004

Cited by 131 publications

(112 citation statements)

References 29 publications

(41 reference statements)

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“…Despite this approach, we found no impact of these indicators of disease severity on the risk of cognitive impairment. This differs from some previous work, 41 but is similar to other studies that found no association between disease severity and cognitive impairment. 42 Our results reveal a disconnect between global measures of COPD severity, which were not related to cognitive impairment, and decreased resting oxygenation, which was strongly associated with decreased cognitive function.…”

Section: Discussionsupporting

confidence: 81%

COPD and cognitive impairment: the role of hypoxemia and oxygen therapy

Thakur

Blanc²,

Julián³

et al. 2010

COPD

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Section: Discussionsupporting

confidence: 81%

COPD and cognitive impairment: the role of hypoxemia and oxygen therapy

Thakur

Blanc²,

Julián³

et al. 2010

COPD

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“…3) Individual characteristics such as age, cultural factors, work status and cognitive capacity [50][51][52][53][54].…”

Section: Questionnaires (Subjective or Self-reported Methods)mentioning

confidence: 99%

Quantifying physical activity in daily life with questionnaires and motion sensors in COPD

Pitta¹,

Troosters²,

Probst³

et al. 2006

Eur Respir J

406

323

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Accurate assessment of the amount and intensity of physical activity in daily life is considered very important due to the close relationship between physical activity level, health, disability and mortality. For this reason, assessment of physical activity in daily life has gained interest in recent years, especially in sedentary populations, such as patients with chronic obstructive pulmonary disease (COPD).The present article aims to compare and discuss the two kinds of instruments more commonly used to quantify the amount of physical activity performed by COPD patients in daily life: subjective methods (questionnaires, diaries) and motion sensors (electronic or mechanical methods). Their characteristics are summarised and evidence of their validity, reliability and sensitivity is discussed, when available.Subjective methods have practical value mainly in providing the patients' view on their performance in activities of daily living and functional status. However, care must be taken when using subjective methods to accurately quantify the amount of daily physical activity performed. More accurate information is likely to be available with motion sensors rather than questionnaires. The selection of which motion sensor to use for quantification of physical activity in daily life should depend mainly on the purpose of its use.

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“…The clinical implications of an alteration in the autonomic nervous system and cerebrovascular dynamics are clear when considering the recently reported high sensitivity of the solitary tract nucleus to changes in blood flow [38]. Additionally, the alteration in cerebrovascular dynamics may affect cognitive performance [5,6,39]. This, together with blood gas abnormalities occurring in the natural history of COPD, may be an important factor conditioning cognitive impairment seen in these patients [39].…”

Section: Autonomic Disturbances In Copd Patientsmentioning

confidence: 99%

“…In turn, alteration in cerebral blood flow may be an important determinant of the cognitive impairment reported in these patients [5,6], and may also contribute to the worsening of the autonomic and respiratory abnormalities by impairing the perfusion of brainstem regulatory centres. However, smoking is a common habit of COPD patients and, although only few studies (and none in COPD patients) have reported on the chronic effect of smoking on the cerebrovascular dynamics [7][8][9], smoking seems capable of inducing long-term cerebrovascular changes [9].…”

mentioning

confidence: 99%

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

Bernardi¹,

Casucci²,

Haider³

et al. 2008

Eur Respir J

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Patients with chronic obstructive pulmonary disease (COPD) may develop hypercapnia and hypoxia, two main determinants of cerebral blood flow. The current authors tested whether cerebrovascular regulation was altered in mild COPD, modified by manoeuvres acutely improving autonomic cardiovascular modulation or influenced by smoking habit.In 15 eucapnic normoxic mild COPD patients (eight smokers) and 28 age-matched controls (14 smokers), midcerebral artery blood flow velocity (MCFV), end-tidal carbon dioxide tension (PET,CO 2 ), arterial oxygen saturation (Sa,O 2 ), ECG and blood pressure at rest were monitored during progressive hypercapnic hyperoxia, isocapnic hypoxia, slow breathing and oxygen administration. MCFV, arterial baroreflex and dynamic MCFV-blood pressure relationships were compared by phase analysis.COPD and control smokers showed higher MCFV (when corrected for PET,CO 2 ), lower cerebrovascular resistance index and lower sensitivity to hypercapnia than nonsmokers, with equal sensitivity to Sa,O 2 and similar phase analysis. Arterial baroreflex was depressed in all COPD patients. Slow breathing and oxygen administration improved baroreflex sensitivity and reduced MCFV in all COPD patients.Patients with mild chronic obstructive pulmonary disease show autonomic dysfunction. Chronic smoking induces cerebral vasodilation and impairs cerebrovascular control. All abnormalities can be partly corrected by improving the cardio-and cerebrovascular autonomic modulation, suggesting that functional autonomic abnormalities are already present at an early stage of disease.

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Cognitive performance in patients with COPD

Cited by 131 publications

References 29 publications

COPD and cognitive impairment: the role of hypoxemia and oxygen therapy

COPD and cognitive impairment: the role of hypoxemia and oxygen therapy

Quantifying physical activity in daily life with questionnaires and motion sensors in COPD

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

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