Chronic obstructive pulmonary disease. An original model of cognitive decline.

In order to characterize the neuropsychologic profile of patients with hypoxic-hypercapnic chronic obstructive pulmonary disease (COPD), the performance of 36 patients with COPD 69 +/- 10 yr of age (mean +/- SD) on 19 tests exploring eight cognitive domains was compared with those of 29 normal adults (69 +/- 7 yr of age), 20 normal elderly adults (78 +/- 2 yr of age), 26 patients with Alzheimer-type dementia (72 +/- 6 yr of age), and 28 with multi-infarct dementia (MID) (70 +/- 8 yr of age). The discriminant analysis of cognitive test scores showed that 48.5% of patients with COPD had a specific pattern of cognitive deterioration characterized by a dramatic impairment in verbal and verbal memory tasks, well-preserved visual attention, and diffuse worsening of the other functions. The remaining patients with COPD were functionally classified as normal adults (12.1%), normal elderly adults (15.2%), those with MID (12.1%), and those with Alzheimer-type dementia (12.1%) according to discriminant analysis. Cognitive impairment was significantly and positively correlated with age (p < 0.05) and duration of hypoxic-hypercapnic chronic respiratory failure (p < 0.05). Because patients with COPD were receiving oxygen therapy from the beginning of oxyhemoglobin desaturation, results suggest that continuous oxygen therapy does not prevent or only partly prevents cognitive decline in COPD. Although some analogies between age-related and COPD-related cognitive decline are evident, a distinct cognitive profile was found in a large fraction of patients with COPD and it differs in several aspects from those of both normal and demented subjects.

[1]  G. Alexopoulos,et al.  Diagnosing cognitive dysfunction in the elderly: primary screening tests. , 1991, Geriatrics.

[2]  C. Marra,et al.  Double Dissociation Between Temporal and Spatial Pattern Processing in Patients with Frontal and Parietal Damage , 1990, Cortex.

[3]  F. Speizer.  Overview and Summary , 1989 .

[4]  L R White,et al.  Correlates of cognitive function in an elderly community population. , 1988, American journal of epidemiology.

[5]  M. Drake.  Diagnostic and Statistical Manual of Mental Disorders (3rd ed. rev.) , 1988 .

[6]  M. Mesulam,et al.  Right cerebral dominance in spatial attention. Further evidence based on ipsilateral neglect. , 1987, Archives of neurology.

[7]  A. Stracciari,et al.  Neuropsychological assessment of mental deterioration: purpose of a brief battery and a probabilistic definition of “normality” and “non‐normality” , 1986, Acta psychiatrica Scandinavica.

[8]  Forster Pj.  Effect of different ascent profiles on performance at 4,200 m elevation. , 1985 .

[9]  T. Salthouse,et al.  Division of attention: Age differences on a visually presented memory task , 1984, Memory & cognition.

[10]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[11]  I Grant,et al.  Psychologic effects of continuous and nocturnal oxygen therapy in hypoxemic chronic obstructive pulmonary disease. , 1983, Archives of internal medicine.

[12]  H. Kehlet,et al.  Immediate and Long‐term Mental Recovery from General versus Epidural Anesthesia in Elderly Patients , 1983 .

[13]  A. J. Block,et al.  Oxygen desaturation during sleep as a determinant of the "Blue and Bloated" syndrome. , 1981, Chest.

[14]  C Caltagirone,et al.  Validity of some neuropsychological tests in the assessment of mental deterioration , 1979, Acta psychiatrica Scandinavica.

[15]  J. Blass,et al.  Consequences of mild, graded hypoxia. , 1979, Advances in neurology.

[16]  N. Lassen,et al.  Multi-infarct dementia. A cause of mental deterioration in the elderly. , 1974, Lancet.

[17]  D. Featherman,et al.  On the Measurement of Occupation in Social Surveys , 1973 .

[18]  A J Block,et al.  Neuropsychologic effects of continuous oxygen therapy in chronic obstructive pulmonary disease. , 1973, Chest.

[19]  M. Albert.  A simple test of visual neglect , 1973, Neurology.

[20]  M. J. Dulfano,et al.  Hypercapnia: mental changes and extrapulmonary complication. An expanded concept of the "CO-2 intoxication" syndrome. , 1965, Annals of internal medicine.

[21]  J. Goldsmith.  Epidemiology of Bronchitis and Emphysema , 1965 .

[22]  Edwin G. Olds,et al.  The 5% Significance Levels for Sums of Squares of Rank Differences and a Correction , 1949 .

[23]  H. B. Mann,et al.  On a Test of Whether one of Two Random Variables is Stochastically Larger than the Other , 1947 .