Impact Study On Cognitive Function In Patients With COPD Based On Health Ecological Model

Objective:1.To investigate the cognitive function of patients with COPD by cross-sectional survey,and fully analyze the relationship between kinds of factors and cognitive function based on the health ecology model,which include personal trait,behavior characteristics,social network and conditions of life and working.2.Bibliography study and statistic analysis were used to identify multiple meaningful variables,in order to establish structural equation modeling about cognitive function and make the relationship between the measured variables and latent variables clearly to explain the functional mechanism.Methods:A total of 212 patients with COPD were investigated in the respiratory department from a major hospital in Tianjin,China,from Oct 2016 to Nov 2017.We built the questionnaires based on the health ecology model to investigate cognitive function in patients with COPD.According to structural equation model,we analysed functional mechanism between the influencing factors.Results:1.The status of cognitive function the scores of MMSE and MOCA were24.18?SD=3.82?,21.45?SD=4.78?,respectively.Based on the criteria of the cognitive assessment scales above for the cognitive impairment,A total of 143 patients with COPD with cognitive impairment were assessed by MoCA.A total of 107 patients with COPD with cognitive impairment were assessed by MMSE.There was significant difference between the incidences of MMSE and MoCA?P<0.001?.2.The status of cognitive impairment Patients with COPD assessed by MMSE got full score in each domain sorted from most to least is language ability?4.7%?,delayed memory?34.0%?,attention and calculation?56.6%?,in turn.Patients with COPD assessed by MoCA got full score in each domain sorted from most to least is delayed memory?0.5%?,abstract?13.2%?,visual space and executive ability?26.9%?,in turn.3.The result showed that there were seven predictors which influenced cognitive function:,age,personalmonthlyincome,drinking,CRP,HCO3?,social support,depression and sleep quality.4.Structural equation model Clinical indicators were important mediating variables affecting the cognitive function of patients with COPD,which adjusted age,drinking,social support and other factors influcing cognitive function.Both overall effect and indirect effect showed that social support had the greatest influence on the cognitive function of patients with COPD.Conclusion:1.The incidence of cognitive dysfunction was higher in patients with COPD.When patients were assessed by MMSE,the area of language ability,delayed memory,attention and calculation was severely damaged.When patients were assessed by MoCA,the area of delayed memory,abstract,visual space and executive ability were severely damaged.2.Correlation analysis showed that the cognitive function in patients with COPD was positively correlated with social support,and was negatively correlated with the sleep quality and depression.The values of SpO₂,CRP and HCO₃?were closely related to the cognitive impairment.3.Based on the criteria of MoCA scale,there were seven predictors which influenced cognitive function:,age,personal monthly income,drinking,CRP,HCO₃?,social support,depression and sleep quality.4.In this study,we built structural equation model and found clinical indicators as important intervening variable.Social support has a great impact on cognitive function,so the important way to help patients improve cognitive function is to fully mobilize and exert the potential of social support.