Cognitive function during exacerbations of Chronic Obstructive Pulmonary Disease.

PURPOSE OF THE STUDY: To determine the prevalence and time course of cognitive impairment in COPD patients during and after an admission to hospital with an exacerbation of COPD.

STUDY DESIGN: Patients admitted to hospital with an exacerbation of COPD between October 2013 and November 2014 were administered the Montreal Cognitive Assessment (MoCA) tool, COPD assessment test (CAT), and modified BORG dyspnoea scale at three points in time: within 24 hours of admission, between 48 and 72 hours after admission and 6 weeks post discharge.

RESULTS: 25 patients agreed to participate. Four withdrew from the study after the initial evaluation. The mean (range) CAT score 24 hours after admission was 26 (18 to 37). Cognitive impairment was found in 19/25 (76%) patients at the initial evaluation, 16/21 (76%) patients at the second evaluation. Overall 22/25 (88%) showed cognitive impairment within 72 hours of an exacerbation of COPD. 14/21 (66%) patients showed cognitive impairment at the final evaluation. The mean MoCA scores improved from admission (22.6) to the second evaluation (23.3) to the final evaluation 3 (24.4), but this change was not statistically significant.

CONCLUSION: Cognitive impairment is highly prevalent during hospital admissions with an exacerbation of COPD. This impairment does improve with time, but only a minority recover to within a normal range. This will affect patients' abilities to understand and remember information given to them in hospital and adhere to medication regimes. This article is protected by copyright. All rights reserved.