Andrianopoulos Vasileios, Gloeckl Rainer, Vogiatzis Ioannis, Kenn Klaus
Dept of Respiratory Medicine and Pulmonary Rehabilitation, Schön Klinik Berchtesgadener Land, Schönau am Königssee, Germany.
Dept for Prevention, Rehabilitation and Sports Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
Breathe (Sheff). 2017 Mar;13(1):e1-e9. doi: 10.1183/20734735.001417.
Cognitive impairment is highly prevalent in patients with COPD and demonstrates multiple detrimental effects on many aspects of patient state and therapeutic outcomes. It is attributed to several overlapping pathophysiological factors, with the most common being the low level of oxygen saturation due to respiratory insufficiency. Despite the impact of cognitive impairment on clinical outcomes, the screening for coexisting cognitive deficits which may interfere with the successful progress of respiratory treatment is yet neglected. There is a special consideration that cognitive deficits should be taken into account when developing respiratory therapy plans. Cognitively impaired patients are likely to require more support and have need of an individualised respiratory care plan which can also be beneficial for their cognitive deficits. Pulmonary rehabilitation as a multidisciplinary approach could be prioritised for COPD patients with cognitive impairment.
To illustrate the common signs of cognitive impairment and define potential associations between lung and cognitive dysfunction.To illustrate the potential influence of cognitive deficits on the optimal progress of respiratory therapy.To illustrate the importance of cognitive evaluation as part of a comprehensive clinical assessment for patients suspected of suffering cognitive impairment.
认知障碍在慢性阻塞性肺疾病（COPD）患者中非常普遍，并且对患者状态和治疗结果的许多方面都有多种不利影响。它归因于几个重叠的病理生理因素，最常见的是呼吸功能不全导致的氧饱和度水平低。尽管认知障碍对临床结果有影响，但对可能干扰呼吸治疗成功进展的并存认知缺陷的筛查仍被忽视。在制定呼吸治疗计划时应特别考虑认知缺陷。认知受损的患者可能需要更多支持，并且需要个性化的呼吸护理计划，这对他们的认知缺陷也可能有益。对于有认知障碍的COPD患者，可优先采用多学科方法进行肺康复治疗。
阐明认知障碍的常见体征，并确定肺部与认知功能障碍之间的潜在关联。阐明认知缺陷对呼吸治疗最佳进展的潜在影响。阐明认知评估作为疑似认知障碍患者综合临床评估一部分的重要性。
