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. 2019 Nov 14;20(1):257.
doi: 10.1186/s12931-019-1217-5.

The association of cognitive functioning as measured by the DemTect with functional and clinical characteristics of COPD: results from the COSYCONET cohort

Sarah Marietta von Siemens  1 , Robert Perneczky  2   3   4   5 , Claus F Vogelmeier  6 , Jürgen Behr  7   8 , Diego Kauffmann-Guerrero  7 , Peter Alter  6 , Franziska C Trudzinski  9 , Robert Bals  9 , Christian Grohé  10 , Sandra Söhler  11 , Benjamin Waschki  12   13 , Johanna I Lutter  14 , Tobias Welte  15 , Rudolf A Jörres  1 , Kathrin Kahnert  16 ; COSYCONET study group
Collaborators, Affiliations

The association of cognitive functioning as measured by the DemTect with functional and clinical characteristics of COPD: results from the COSYCONET cohort

Sarah Marietta von Siemens et al. Respir Res. .

Abstract

Alterations of cognitive functions have been described in COPD. Our study aimed to disentangle the relationship between the degree of cognitive function and COPD characteristics including quality of life (QoL).Data from 1969 COPD patients of the COSYCONET cohort (GOLD grades 1-4; 1216 male/ 753 female; mean (SD) age 64.9 ± 8.4 years) were analysed using regression and path analysis. The DemTect screening tool was used to measure cognitive function, and the St. George's respiratory questionnaire (SGRQ) to assess disease-specific QoL.DemTect scores were < 9 points in 1.6% of patients and < 13 points in 12% when using the original evaluation algorithm distinguishing between < 60 or > =60 years of age. For statistical reasons, we used the average of both algorithms independent of age in all subsequent analyses. The DemTect scores were associated with oxygen content, 6-min-walking distance (6-MWD), C-reactive protein (CRP), modified Medical Research Council dyspnoea scale (mMRC) and the SGRQ impact score. Conversely, the SGRQ impact score was independently associated with 6-MWD, FVC, mMRC and DemTect. These results were combined into a path analysis model to account for direct and indirect effects. The DemTect score had a small, but independent impact on QoL, irrespective of the inclusion of COPD-specific influencing factors or a diagnosis of cognitive impairment.We conclude that in patients with stable COPD lower oxygen content of blood as a measure of peripheral oxygen supply, lower exercise capacity in terms of 6-MWD, and higher CRP levels were associated with reduced cognitive capacity. Furthermore, a reduction in cognitive capacity was associated with reduced disease-specific quality of life. As a potential clinical implication of this work, we suggest to screen especially patients with low oxygen content and low 6-MWD for cognitive impairment.

Keywords: COPD; Cognitive impairment; Dementia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a. Scores of the DemTect Test versus age for men (blue circles) and women (red circles) separately as evaluated according to the original algorithm. b. Scores of the DemTect Test versus age for men (blue circles) and women (red circles) separately as obtained by averaging the two different evaluation algorithms that were applied independent of age
Fig. 2
Fig. 2
Estimated changes in the DemTect score for defined changes in predictors according to the regression coefficients given in table 2b
Fig. 3
Fig. 3
Path analysis model of the major variables evaluated in the present study
See this image and copyright information in PMC

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