{"title":"尼泊尔慢性阻塞性肺疾病患者的认知障碍：一项横断面研究","authors":"Pashupati Pokharel, Surakshya Khanal, Ranjeet Ghimire, Arun Batsa Lamsal, Rebanta Khadka, Rabin Pandit, Kailash Mani Pokhrel, Kapil Khanal, Pratik Lamichhane, Ramesh Kumar Maharjan, Pankaj Pant","doi":"10.1002/hsr2.71315","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Aims</h3>\n \n <p>Chronic Obstructive Pulmonary Disease (COPD) is associated with cognitive impairment, including memory loss, executive dysfunction and attention deficits all of which significantly affect quality of life. However, the prevalence and determinants of cognitive impairment among COPD patients in Nepal remain largely unexplored.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This cross-sectional study included a total of 203 COPD patients admitted to a tertiary hospital in Nepal between August 2022 and June 2023. Sociodemographic, clinical, and biochemical data were collected from the patients. Cognitive functions were assessed using the Nepali-translated Rowland Universal Dementia Assessment Scale. Logistic regression analysis was conducted to identify factors associated with cognitive impairment.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The mean age of COPD patients was 68.4 ± 10.2 years, with most from the age group 65–75 years, and nearly 2/3rd (63.5%) were females. A majority (62.6%) lacked formal education, and 81.3% were smokers (current or former). Clinically, 45.3% of patients had grade III dyspnea, and 37.9% had pneumonia. Among the patients, 11.8% patients experienced more than five exacerbations in the past year, and 43.4% required more than one hospital admission during the previous year.</p>\n \n <p>Cognitive impairment was prevalent in majority of the patients, with 46.3% exhibiting mild cognitive impairment and 42.9% exhibiting dementia. Factors associated with cognitive impairment included increasing age of COPD patients (≥ 65 years) (OR 2.72; <i>p</i> = 0.003), having more than one COPD exacerbation in a year (OR 3.90; <i>p</i> = 0.002), years of living with COPD (≥ 10 years) (OR 0.47; <i>p</i> = 0.016), frequent COPD exacerbation related hospitalization (OR 0.29; <i>p</i> = 0.004), and lower blood PaCO<sub>2</sub> levels (OR 0.26; <i>p</i> = 0.007).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Nearly 90% of COPD patients in Nepal had some form of cognitive decline. Age, exacerbation frequency, and PaCO₂ levels were significant predictors. Routine cognitive screening and targeted interventions like integrated rehabilitation strategies, including pulmonary rehabilitation and oxygen therapy are essential to enhance patient outcomes and reduce disease burden in future.</p>\n </section>\n </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 10","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.71315","citationCount":"0","resultStr":"{\"title\":\"Cognitive Impairment Among Chronic Obstructive Pulmonary Disease Patients of Nepal: A Cross-Sectional Study\",\"authors\":\"Pashupati Pokharel, Surakshya Khanal, Ranjeet Ghimire, Arun Batsa Lamsal, Rebanta Khadka, Rabin Pandit, Kailash Mani Pokhrel, Kapil Khanal, Pratik Lamichhane, Ramesh Kumar Maharjan, Pankaj Pant\",\"doi\":\"10.1002/hsr2.71315\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and Aims</h3>\\n \\n <p>Chronic Obstructive Pulmonary Disease (COPD) is associated with cognitive impairment, including memory loss, executive dysfunction and attention deficits all of which significantly affect quality of life. However, the prevalence and determinants of cognitive impairment among COPD patients in Nepal remain largely unexplored.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This cross-sectional study included a total of 203 COPD patients admitted to a tertiary hospital in Nepal between August 2022 and June 2023. Sociodemographic, clinical, and biochemical data were collected from the patients. Cognitive functions were assessed using the Nepali-translated Rowland Universal Dementia Assessment Scale. Logistic regression analysis was conducted to identify factors associated with cognitive impairment.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The mean age of COPD patients was 68.4 ± 10.2 years, with most from the age group 65–75 years, and nearly 2/3rd (63.5%) were females. A majority (62.6%) lacked formal education, and 81.3% were smokers (current or former). Clinically, 45.3% of patients had grade III dyspnea, and 37.9% had pneumonia. Among the patients, 11.8% patients experienced more than five exacerbations in the past year, and 43.4% required more than one hospital admission during the previous year.</p>\\n \\n <p>Cognitive impairment was prevalent in majority of the patients, with 46.3% exhibiting mild cognitive impairment and 42.9% exhibiting dementia. Factors associated with cognitive impairment included increasing age of COPD patients (≥ 65 years) (OR 2.72; <i>p</i> = 0.003), having more than one COPD exacerbation in a year (OR 3.90; <i>p</i> = 0.002), years of living with COPD (≥ 10 years) (OR 0.47; <i>p</i> = 0.016), frequent COPD exacerbation related hospitalization (OR 0.29; <i>p</i> = 0.004), and lower blood PaCO<sub>2</sub> levels (OR 0.26; <i>p</i> = 0.007).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Nearly 90% of COPD patients in Nepal had some form of cognitive decline. Age, exacerbation frequency, and PaCO₂ levels were significant predictors. Routine cognitive screening and targeted interventions like integrated rehabilitation strategies, including pulmonary rehabilitation and oxygen therapy are essential to enhance patient outcomes and reduce disease burden in future.</p>\\n </section>\\n </div>\",\"PeriodicalId\":36518,\"journal\":{\"name\":\"Health Science Reports\",\"volume\":\"8 10\",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-10-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hsr2.71315\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Science Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/hsr2.71315\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Science Reports","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hsr2.71315","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景和目的慢性阻塞性肺疾病（COPD）与认知障碍相关，包括记忆丧失、执行功能障碍和注意力缺陷，所有这些都会显著影响生活质量。然而，尼泊尔COPD患者认知障碍的患病率和决定因素在很大程度上仍未被探索。方法本横断面研究纳入了2022年8月至2023年6月在尼泊尔一家三级医院住院的203例COPD患者。收集患者的社会人口学、临床和生化数据。使用尼泊尔语翻译的罗兰通用痴呆评估量表评估认知功能。进行Logistic回归分析以确定与认知障碍相关的因素。结果慢性阻塞性肺病患者的平均年龄为68.4±10.2岁，以65 ~ 75岁年龄组居多，女性占63.5%。大多数（62.6%）缺乏正规教育，81.3%是吸烟者（现在或以前）。临床上45.3%的患者有III级呼吸困难，37.9%的患者有肺炎。在这些患者中，11.8%的患者在过去一年中经历了5次以上的急性发作，43.4%的患者在过去一年中需要住院一次以上。大多数患者存在认知障碍，其中46.3%表现为轻度认知障碍，42.9%表现为痴呆。与认知功能障碍相关的因素包括COPD患者年龄增加（≥65岁）（OR 2.72; p = 0.003）、一年内COPD加重一次以上（OR 3.90; p = 0.002）、COPD生存年限（≥10年）（OR 0.47; p = 0.016）、COPD加重相关的频繁住院（OR 0.29; p = 0.004）和血液PaCO2水平降低（OR 0.26; p = 0.007）。尼泊尔近90%的COPD患者存在某种形式的认知能力下降。年龄、加重频率和PaCO 2水平是显著的预测因子。常规认知筛查和有针对性的干预措施，如综合康复策略，包括肺康复和氧气治疗，对于提高患者预后和减轻未来疾病负担至关重要。
Cognitive Impairment Among Chronic Obstructive Pulmonary Disease Patients of Nepal: A Cross-Sectional Study
Background and Aims
Chronic Obstructive Pulmonary Disease (COPD) is associated with cognitive impairment, including memory loss, executive dysfunction and attention deficits all of which significantly affect quality of life. However, the prevalence and determinants of cognitive impairment among COPD patients in Nepal remain largely unexplored.
Methods
This cross-sectional study included a total of 203 COPD patients admitted to a tertiary hospital in Nepal between August 2022 and June 2023. Sociodemographic, clinical, and biochemical data were collected from the patients. Cognitive functions were assessed using the Nepali-translated Rowland Universal Dementia Assessment Scale. Logistic regression analysis was conducted to identify factors associated with cognitive impairment.
Results
The mean age of COPD patients was 68.4 ± 10.2 years, with most from the age group 65–75 years, and nearly 2/3rd (63.5%) were females. A majority (62.6%) lacked formal education, and 81.3% were smokers (current or former). Clinically, 45.3% of patients had grade III dyspnea, and 37.9% had pneumonia. Among the patients, 11.8% patients experienced more than five exacerbations in the past year, and 43.4% required more than one hospital admission during the previous year.
Cognitive impairment was prevalent in majority of the patients, with 46.3% exhibiting mild cognitive impairment and 42.9% exhibiting dementia. Factors associated with cognitive impairment included increasing age of COPD patients (≥ 65 years) (OR 2.72; p = 0.003), having more than one COPD exacerbation in a year (OR 3.90; p = 0.002), years of living with COPD (≥ 10 years) (OR 0.47; p = 0.016), frequent COPD exacerbation related hospitalization (OR 0.29; p = 0.004), and lower blood PaCO2 levels (OR 0.26; p = 0.007).
Conclusion
Nearly 90% of COPD patients in Nepal had some form of cognitive decline. Age, exacerbation frequency, and PaCO₂ levels were significant predictors. Routine cognitive screening and targeted interventions like integrated rehabilitation strategies, including pulmonary rehabilitation and oxygen therapy are essential to enhance patient outcomes and reduce disease burden in future.
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