Pneumologie 2020; 74(S 01): 83-84
DOI: 10.1055/s-0039-3403247
Freie Vorträge (FV12) – Sektion Klinische Pneumologie
Hot Topics der klinischen Pneumologie
Georg Thieme Verlag KG Stuttgart · New York

The association of cognitive functioning as measured by the DemTect with clinical and functional characteristics of COPD

M von Siemens
1   Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine
,
R Perneczky
2   Klinik für Psychiatrie und Psychotherapie, Sektion für Psychische Gesundheit Im Alter, Klinikum der Universität München
,
C Vogelmeier
3   Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Phillips-University Marburg, Germany, Member of the German Centre for Lung Research (Dzl)
,
J Behr
4   Medizinische Klinik und Poliklinik V, Comprehensive Pneumology Center, Klinikum der LMU München
,
D Kauffmann-Guerrero
5   Klinikum der Universität München LMU
,
P Alter
6   Innere Medizin, Sp Pneumologie, Universitätsklinikum Gießen u. Marburg, Standort Marburg
,
FC Trudzinski
7   Innere Medizin V, Pneumologie, Universitätsklinikum des Saarlandes, Homburg
,
R Bals
8   Innere Medizin V, Pneumologie, Universitätsklinikum des Saarlandes, Homburg
,
C Grohé
9   Klinik für Pneumologie, Evangelische Lungenklinik Berlin, Krankenhausbetriebs gGmbH
,
S Söhler
10   Philipps-Universität Marburg
,
B Waschki
11   Department of General and Interventional Cardiology, University Heart Center Hamburg
,
J Lutter
12   Helmholtz Zentrum München, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen; Comprehensive Pneumology Center Munich (Cpc-M), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
,
T Welte
13   Klinik für Pneumologie, Medizinische Hochschule Hannover
,
R Jörres
14   Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München, LMU München
,
K Kahnert
15   Department of Internal Medicine V, Respiratory Medicine and Thoracic Oncology, Thoracic Oncology Centre Munich, Ludwig-Maximilians-Universität München, Member of the German Center for Lung Research (Dzl Cpc-M)
› Author Affiliations
Further Information

Publication History

Publication Date:
28 February 2020 (online)

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    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. Georgeʼs 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-minute-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.


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