Cognitive function and living situation in COPD: is there a relationship with self-management and quality of life?
Cognitive function and living situation in COPD: is there a relationship with self-management and quality of life?
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DOI：
10.2147/copd.s88035
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发表时间：
2015-01-01
影响因子：
2.8
通讯作者：
Benzo, Roberto P.
中科院分区：
文献类型：
--
作者：
Dulohery, Megan M.;Schroeder, Darrell R.;Benzo, Roberto P.
背景：认知功能障碍越来越多地被发现是慢性阻塞性肺疾病（COPD）的常见合并症。本研究旨在了解全面测量的认知功能与COPD严重程度，生活质量，生活状况，卫生保健利用和自我管理能力的关系。使用蒙特利尔认知评估（莫卡）评估认知功能。自我管理能力采用自我管理能力得分30来衡量。使用慢性呼吸系统疾病问卷测量生活质量。Pearson相关性用于评估莫卡与其他研究指标的双变量相关性。多变量分析是为了了解莫卡和生活状况对COPD住院结局、生活质量和自我管理能力的相互作用。这项研究包括100名平均年龄为70 +/- 9.4岁的参与者（63%男性，37%女性）患有COPD（平均FEV 1 [1秒用力呼气量]百分比预测值为40.4 +/- 16.7）。平均莫卡评分为23.8 +/- 3.9，63%的患者有轻度认知障碍。莫卡与年龄呈负相关（r=-0.28，P =0.005），与文化程度呈正相关（r=+0.24，P =0.012）。认知功能与急性加重、急诊室（ER）就诊或住院之间无显著相关性。莫卡评分与自我管理能力或生活质量之间没有关联。我们测试的生活状况和莫卡与自我管理能力的相互作用，发现统计学意义（P= 0.017），表明单独居住的人具有较高的认知功能报告较低的自我管理能力。结论：认知功能障碍在COPD并没有出现有意义的COPD严重程度，健康状况，或自我管理能力。由于诊断为COPD，可能不需要进行认知功能障碍的常规筛查。独居显著影响自我管理能力与认知功能的交互作用。
Background: Cognitive impairment is increasingly being found to be a common comorbidity in chronic obstructive pulmonary disease (COPD). This study sought to understand the relationship of comprehensively measured cognitive function with COPD severity, quality of life, living situation, health care utilization, and self-management abilities.Methods: Subjects with COPD were recruited from the outpatient pulmonary clinic. Cognitive function was assessed using the Montreal Cognitive Assessment (MOCA). Self-management abilities were measured using the Self Management Ability Score 30. Quality of life was measured using the Chronic Respiratory Disease Questionnaire. Pearson correlation was used to assess the bivariate association of the MOCA with other study measures. Multivariate analysis was completed to understand the interaction of the MOCA and living situation on COPD outcomes of hospitalization, quality of life, and self-management ability.Results: This study included 100 participants of mean age 70 +/- 9.4 years (63% male, 37% female) with COPD (mean FEV1 [forced expiratory volume in 1 second] percentage predicted 40.4 +/- 16.7). Mean MOCA score was 23.8 +/- 3.9 with 63% of patients having mild cognitive impairment. The MOCA was negatively correlated with age (r=-0.28, P=0.005) and positively correlated with education (r=+0.24, P=0.012). There was no significant correlation between cognitive function and exacerbations, emergency room (ER) visits, or hospitalizations. There was no association between the MOCA score and self-management abilities or quality of life. We tested the interaction of living situation and the MOCA with self-management abilities and found statistical significance (P= 0.017), indicating that individuals living alone with higher cognitive function report lower self-management abilities.Conclusion: Cognitive impairment in COPD does not appear to be meaningfully associated with COPD severity, health outcomes, or self-management abilities. The routine screening for cognitive impairment due to a diagnosis of COPD may not be indicated. Living alone significantly affects the interaction between self-management abilities and cognitive function.