Dodd, James W; Charlton, Rebecca A; van den Broek, Martin D and Jones, Paul W. 2013. Cognitive Dysfunction in Patients Hospitalized with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD). Chest, pp. 1-8. ISSN 1931-3543 [Article]

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Abstract or Description

ABSTRACT RATIONALE: Cognitive impairment is one of the least well-studied COPD comorbidities. It is known to occur in hypoxemic patients, but its presence during acute exacerbation is not established. OBJECTIVES: To assess neuropsychological performance in COPD patients awaiting discharge from hospital following acute exacerbation and recovery and compare with stable outpatients with COPD and healthy controls. METHODS: 110 participants were recruited: 30 COPD in-patients awaiting discharge following an exacerbation, 50 stable COPD outpatients, and 30 controls. Neuropsychological tests measured episodic memory, executive function, visuo-spatial function, working memory, processing speed and an estimate of premorbid abilities. Follow up cognitive assessments for stable and exacerbating patients were completed at 3 months. RESULTS: Exacerbators were significantly worse (p<0.05) than stable patients over a range of measures of cognitive function, independent of hypoxemia, disease severity, cerebrovascular risk or pack years smoked. In exacerbators up to 57% were in the impaired range and 20% were considered to have suffered a pathological loss in processing speed. Impaired cognition was associated with worse SGRQ score (r=-0.40-0.62 p≤0.02) and longer length of stay (r=0.42, p =0.02). There was no improvement in any aspect of cognition at recovery three months later. CONCLUSION: In patients hospitalized with an acute exacerbation impaired cognitive function is associated with worse health status and greater hospital length of stay. A significant proportion of patients are discharged home with unrecognized mild-severe cognitive impairment, which may not improve with recovery.

Item Type:	Article
Departments, Centres and Research Units:	Psychology
Dates:	Date Event 24 January 2013 ["eprint_fieldopt_dates_date_type_inproduction" not defined]
Item ID:	8312
Date Deposited:	09 Jun 2013 12:42
Last Modified:	30 Jun 2017 14:11
Peer Reviewed:	Yes, this version has been peer-reviewed.
URI:	https://research.gold.ac.uk/id/eprint/8312

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