| Objective:Our purpose was to understand the status of the cognitive function in patients with chronic obstructive pulmonary disease(Chronic Obstructive Pulmonary Disease,COPD),and to explore the influencing factors of cognitive function in patients with COPD,so as to get some ideas and reference for preventing or delaying the damage of cognitive function in patients with COPD.Methods:Two hospitals were randomly selected from the three grade hospitals in changsha,and the patients with COPD who were hospitalized in the two hospitals from May 2017 to December 2017 were selected as the research subjects.Participants who met inclusion andexclusion criteria and informed consent completed the General infor-mation questionnaire,Montreal Cognitive Assessment scale,Hospital Anxiety and Depression Scale,Pittsburgh Sleep Quality Index,Activity of Daily Living were used to patients who met the inclusion,exclusioncriteria and informed consent by field questionnaire survey.All data were analyzed by using SPSS22.0 statistical software,and the main statistical methods were descriptive analysis,Chi-squaretest,t t-est,Pearson or Spearman correlation analysis,Logistic regression analysis,etc.Results:(1)The cognitive function scores of 252 COPD patients were(23.56±2.58),with a range of 16 to 29 points,the dimension scores were:Visual space executive function(3.21 ± 0.84),Naming(2.66 ± 0.57),Calculation and Attention(5.49 ± 0.73),Language(1.90 ± 0.64),ion(1.25 ± 0.64),Delayed recall(2.54 ± 0.94),Orientation(5.62± 0.53).The total score of cognitive function and the scores of each dimension were significantly lower than that of domestic norm,and the difference was statistically significant(P<0.01).In COPD patients,there were 193 cases(76.6%)of cognitive function score of less than 26.In this study,the patients’ cognitive function in each field were Delayed recall,ion,Language,Visual space executive function,Naming,Calculation and Attention,Orientation.(2)The scores of anxiety and depression,sleep quality and daily activity ability of patients with COPD were as follows.①The median and interquartile range of anxiety scores in patients with COPD were 5.00 and 4.00 respectively,and the median and quartile range of depression scores were 6.00 and 5.00 respectively.There were 162 people(64.3%)of those who scored less than 8.00 in anxiety and depression,and 55 cases(21.8%)of anxiety scores were greater than or equal to eight scores.there were 90 patients(35.7%)who scored more than eight scores for depression.②The total score of PSQI in COPD patients was(8.52 ± 3.42),the scores in each dimension respectively were sleep quality(1.45 ± 0.77),sleep latency(1.58 ± 0.99),sleep time(1.15 ± 0.77),sleep efficiency(1.12± 1.21),sleep disorder(1.3 8 ±0.62),use of hypnotic drugs(0.04 ±0.34),daytime dysfunction(1.53 ± 0.94).Except for the use of hypnotic drug,the total scores of sleep quality and other dimensions were higher than those of norm,and the differences were statistically significant(P<0.05).③The median score and interquartile range of daily living ability in patients with COPD were 18.00,5.00,which 90 patients(35.7%)had normal daily living ability and 162(64.3%)patients had varying degrees of impairment of daily living ability.(3)The results of univariate analysis showed that the different ages,levels of education,monthly household income,types of medical payment,smoking history,the duration of the disease,time in hospital every year,pulmonary function classification,degree of dyspnea,the difference in the scores of cognitive function in patients with COPD was statistically significant(P<0.05).And the value of its x2 were 25.124,21.098,8.370,10.177,13.557,7.897,10.722,45.595 and 35.335.(4)The results of correlation analysis about anxiety showed that the scores of anxiety,depression,sleep quality,daily living ability were negatively correlated with cognitive function(P<0.05).(5)The results of multivariate logistic regression analysis showed that a total of six factors into regression analysis model were respectively age(Xi),level of education(X2),pulmonary function classification(Xs),depression(X11),sleep disorder(X12),daily living disabilities(X13),Chi-square test was performed for the established regression equation model,which indicated that the regression equation has statistically significant(x2=63.468,P<0.01).Conclusions:(1)The cognitive function of patients with COPD was worse than that of the general population,and its Visual space execution function,Delayed recall,Language,Abstraction,Attention,Orientation and Naming function had some degrees of damage.(2)The main factors influencing the cognitive function of patients with COPD were age,level of education,pulmonary function classification,depression,sleep disorder,daily living disabilities.Among them,Age,pulmonary function classification,depression,sleep disorder and daily activity disability were risk factors for cognitive dysfunction,and education was a protective factor. |
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