P97 A cross-sectional analysis of domain specific cognitive impairment in chronic obstructive pulmonary disease

Introduction and ObjectivesThe typical profile of patients with Chronic Obstructive Pulmonary Disease (COPD) includes a wide range of co-morbidity, with increasing evidence demonstrating an association between COPD and cognitive impairment. This cross-sectional study aims to demonstrate domain specific cognitive function and deficit in patients with mild-moderate COPD using the comprehensive Addenbrookes Cognitive Examination-III assessment (ACE-III). It also aims to compare the nature of cognitive impairment in patients with COPD to patients with Alzheimer’s type dementia (AD).MethodsWe enrolled 44 patients with mild or moderate COPD, 17 patients with mild or moderate AD and 28 control patients with a similar age profile and gender distribution. We analysed the difference in ACE-III total scores and domain specific scores between the groups and additionally performed logistic regression analyses to account for cardiovascular co-morbidity and smoking exposure.ResultsPatients with COPD had significantly lower total ACE-III scores (p<0.001) compared to the control group with 47.5 percent of patients demonstrating scores below the recognised cut-off score for cognitive impairment of 88 out of 100. This association remained even when accounting for cardiovascular co-morbidity and smoking exposure. There was no significant difference in the visuospatial cognitive domain (p=0.062), however, compared to the control group patients with COPD demonstrated significantly lower scores in memory (p<0.01), attention (p=0.013) fluency (p=0.002) and language (p=0.004) domains. Interestingly the pattern of cognitive impairment in patients with COPD was similar but less severe compared to patients with AD who demonstrated significantly lower total ACE-III scores (p<0.001).ConclusionsThis study demonstrates a high burden of cognitive impairment in patients with COPD. Interestingly the cognitive domains of memory, attention, fluency and language seem to be predominantly affected in this population. These findings further our understanding of cognitive impairment in patients with COPD, with patients exhibiting a similar but less severe pattern of cognitive impairment to that seen in the AD group.