Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia.
Medicina (Kaunas). 2023 Apr 8;59(4):732. doi: 10.3390/medicina59040732.
Cognitive impairment is a common comorbidity in patients with COPD, significantly impacting health and clinical outcomes. Yet it remains under investigated and is largely overlooked. Although the exact cause of cognitive impairment in patients with COPD is still unclear, factors such as hypoxemia, vascular disease, smoking, exacerbation, and physical inactivity have been suggested. While international guidelines recommend identifying comorbidity in patients with COPD, such as cognitive impairment, cognitive assessment is not yet part of the routine assessment. Unidentified cognitive deficits in patients with COPD may have severe impacts on clinical management, resulting in an inability to maintain functional independence, poor self-management, and a greater dropout from pulmonary rehabilitation programs. There is a need to consider cognitive screening as a part of COPD assessment to promote early detection of cognitive impairment. Recognizing cognitive impairment early in the course of the illness allows the development of individualized interventions to meet patients' needs and improve clinical outcomes. Pulmonary rehabilitation should be tailored to cognitively impaired patients with COPD to maximize the benefits and minimize the incompletion rate.
认知障碍是 COPD 患者常见的合并症，严重影响健康和临床结局。然而，它仍然未被充分研究，在很大程度上被忽视了。虽然 COPD 患者认知障碍的确切原因尚不清楚，但缺氧、血管疾病、吸烟、恶化和身体不活动等因素已被提出。尽管国际指南建议识别 COPD 患者的合并症，如认知障碍，但认知评估尚未成为常规评估的一部分。未被识别的 COPD 患者认知缺陷可能对临床管理产生严重影响，导致无法保持功能独立性、自我管理能力差以及从肺康复计划中辍学率更高。需要将认知筛查视为 COPD 评估的一部分，以促进认知障碍的早期发现。在疾病早期识别认知障碍，可以制定个性化干预措施来满足患者的需求并改善临床结局。应根据 COPD 患者的认知障碍情况调整肺康复计划，以最大限度地提高效益并降低完成率。
