Progressive Neuropsychologic Impairment and Hypoxemia

Grant, Igor; Prigatano, George P.; Heaton, Robert K.; McSweeny, A. John; Wright, Elizabeth C.; Adams, Kenneth M.

doi:10.1001/archpsyc.1987.01800230079013

Cited by 164 publications

(46 citation statements)

References 26 publications

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“…Indeed, in the study by Carone et al [5], 81% of the patients studied suffered from COPD, as opposed to 15% only in the present study. The higher frequency of disturbances in cognitive function is well established in COPD patients with chronic hypoxemia under long-term oxygen therapy [29, 31], or in association with severe hypercapnia. In our study, however, the patients included suffered from predominantly restrictive disorders, were in a stable clinical condition, with only moderate hypoxemia, and hypercapnia, and thus not as prone to suffer from neuropsychological disturbances related to their respiratory disorder [27, 32, 33].…”

Section: Discussionmentioning

confidence: 99%

Validity and Reliability of a French Version of the MRF-28 Health-Related Quality of Life Questionnaire

et al. 2004

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Background: Evaluation of health-related quality of life (HRQL) in chronic respiratory failure (CRF) is an important issue for evaluating the impact of treatment. Objectives: To elaborate a French version of the Maugeri Foundation Respiratory Failure Questionnaire (MRF-28) disease-specific HRQL questionnaire and determine its validity and reliability in patients with CRF treated by home mechanical ventilation (HMV). Methods: Forward- and back-translation of the MRF-28 questionnaire; the final version was submitted to 81 patients treated with HMV for CRF, simultaneously with the St. George’s Respiratory Questionnaire (SGRQ), the Short Form 36 (SF-36), and the Hospital Anxiety and Depression scale (HAD). Validity was determined by correlation with previously validated HRQL scores and recorded physiological parameters. Reliability was evaluated by assessing internal consistency and test-retest stability of the MRF-28 scores. Results: The French version of the MRF-28 and its subscores (‘daily activity’, ‘cognitive function’, and ‘invalidity’) were highly significantly correlated with subscores of the SGRQ, the SF-36 and the HAD. Both the MRF-28 and the SGRQ were correlated only with age and the 6-min walk test. The MRF-28 showed high test-retest reliability after 2 weeks (r² = 0.80, p < 0.0001) and high internal consistency (Crohnbachs’ α coefficient: 0.91). Conclusion: The French version of the MRF-28 is a valid and reliable disease-specific questionnaire for assessing HRQL in patients with CRF.

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Section: Discussionmentioning

confidence: 99%

Validity and Reliability of a French Version of the MRF-28 Health-Related Quality of Life Questionnaire

et al. 2004

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“…Specifically, consistent deficits were found in abstract reasoning, memory, and speed of performance, as compared to controls. Grant et al (1987) merged the data from the previously cited studies (i.e., NOTT and IPPB trials) to further examine the neuropsychological results in a larger and more representative (i.e., with varying degrees of hypoxemia) group of patients with COPD. Analysis of variance and post hoc analyses of the data indicated that patients with more progressive/severe hypoxemia typically performed worse on the majority of neuropsychological measures as compared to patients with less severe levels of hypoxemia and controls.…”

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confidence: 99%

Neuropsychological dysfunction in patients suffering from end-stage chronic obstructive pulmonary disease

Crews

Jefferson

Bolduc³

et al. 2001

Archives of Clinical Neuropsychology

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Few studies have examined the neuropsychological sequelae associated with end-stage pulmonary disease. Neuropsychological data are presented for 47 patients with end-stage chronic obstructive pulmonary disease (COPD) who were being evaluated as potential candidates for lung transplantation. Although patients exhibited a diversity of neurocognitive deficits, their highest frequencies of impairment were found on the Selective Reminding Test (SRT). Specifically, over 50% of the patients completing the SRT exhibited impaired immediate free recall and consistent long-term retrieval deficits, while more than 44% of these individuals displayed deficient long-term retrieval. Deficient SRT long-term storage strategies, cued recall, and delayed recall were exhibited by between 26% and 35% of these patients, while more than 32% of this sample displayed elevated numbers of intrusion errors. Over 31% of the patients completing the Wisconsin Card Sorting Test (WCST) failed to achieve the expected number of categories on this measure, while more than 23% of these individuals demonstrated elevated numbers of perseverative errors and total errors. Clinically notable frequencies of impairment (greater than 20% of the sample) were also found on the Trail Making Test (TMT): Part B and the Wechsler Memory Scale-R (WMS-R) Visual Reproduction II subtest. Minnesota Multiphasic Personality Inventory-2 (MMPI-2) personality assessments indicated that patients were experiencing a diversity of somatic complaints and that they may have been functioning at a reduced level of efficiency. These findings are discussed in light of patients' endstage COPD and factors possibly contributing to their neuropsychological test performances. Implications for clinical practice and future research are also included.

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“…For example, studies addressing specifi c cognitive domains (such as executive performance, attention, cognitive speed) might give important clues on which cognitive processes best explain the performance of our patients on the MMSE. Some studies do indicate that patients with COPD present memory impairment, and this could explain at least in part the decline in the MMSE [19][20][21][22][23][24][25] . However, the different clinical characteristics of our patients and of the patients of the aforementioned studies preclude direct comparisons.…”

Section: Discussionmentioning

confidence: 99%

Subclinical encephalopathy in chronic obstructive pulmonary disease

Lima

Oliveira‐Souza

Santos

et al. 2007

Arq. Neuro-Psiquiatr.

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-Background: Clinical and experimental evidence suggests that chronic obstructive pulmonary disease (COPD) is associated with a variety of mental symptoms that range from cognitive slowing to mental confusion and dementia. Purpose: To test the hypothesis that COPD leads to cognitive impairment in the absence of acute confusion or dementia. Method: The global cognitive status of 30 patients with COPD without dementia or acute confusion and 34 controls was assessed with a Brazilian version of the Mini-Mental State Exam (MMSE). Results: The MMSE scores were significantly lower in the patient group and inversely related to the severity of COPD. This finding could not be attributed to age, education, gender, daytime sleepiness, hypoxemia, chronic tobacco use, or associated diseases such as diabetes, depression, high blood pressure or alcoholism. Conclusion: These results suggest the existence of a subclinical encephalopathy of COPD characterized by a subtle impairment of global cognitive ability.KEY WORDS: chronic obstructive pulmonary disease, mini-mental state exam, subclinical encephalopathy. Encefalopatia subclínica na doença pulmonar obstrutiva crônica RESUMO -Contexto:Evidências clínicas e experimentais sugerem que a doença pulmonar obstrutiva crônica (DPOC) se associa a sintomas neurocomportamentais que variam da lentidão cognitiva à confusão mental e à demência. Propósito: Testar a hipótese de que a DPOC pode comprometer a cognição na ausência de estado confusional agudo ou de demência. Método: O estado cognitivo global de 30 pacientes com DPOC sem demência e sem confusão mental aguda e o de 34 controles foi examinado com a versão brasileira do Mini-Exame do Estado Mental (MEEM). Resultados: As pontuações no MEEM mostraram-se significativamente mais baixas nos pacientes, e inversamente relacionadas à gravidade da DPOC. Este achado não pôde ser atribuído a diferenças de idade, escolaridade, sonolência diurna, hypoxemia, tabagismo crônico, ou a doenças associadas como diabetes, depressão, hipertensão arterial ou alcoolismo. Conclusão: Estes resultados sugerem a existência de uma encefalopatia subclínica da DPOC caracterizada por comprometimento sutil da capacidade cognitiva global. PALAVRAS-CHAVE: doença pulmonar obstrutiva crônica, mini-exame do estado mental, encefalopatia subclínica.

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Progressive Neuropsychologic Impairment and Hypoxemia

Cited by 164 publications

References 26 publications

Validity and Reliability of a French Version of the MRF-28 Health-Related Quality of Life Questionnaire

Validity and Reliability of a French Version of the MRF-28 Health-Related Quality of Life Questionnaire

Neuropsychological dysfunction in patients suffering from end-stage chronic obstructive pulmonary disease

Subclinical encephalopathy in chronic obstructive pulmonary disease

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