SESSION TITLE: COPD Medications and Treatment OutcomesSESSION TYPE: Rapid Fire Original InvPRESENTED ON: 10/19/2022 11:15 am - 12:15 pmPURPOSE: COPD is now considered as a complex condition with numerous systemic components. Many neuropsychiatric disorders, viz. anxiety, depression and cognitive dysfunction, substantially contribute to COPD-related morbidity. The incidence of cognitive impairment in COPD varies from 10% to 61%, depending on the study population and the type of neuropsychological assessment.METHODS: We evaluated 184 stable COPD patients to establish a correlation between their cognitive dysfunctions and severity of COPD based on FEV1. Factors contributing to cognitive decline were also assessed. All patients were administered the COPD Assessment Test (CAT) questionnaire. For cognition, the Mini Mental State Examination (MMSE) and the Trail Making Test - Part A (TMT-A) were used. The MMSE questionnaire assesses orientation, recall and language, short-term memory, attention, and calculation.RESULTS: Approximately half (52.2%) of our patients were in the age group of 50-70 years, while 52 (28.3%) patients were more than 70 years. Three-quarters were males and the remaining one-fourth were females. The distribution of patients as per GOLD criteria was: Stage 1 - 16 (8.7%), Stage 2 - 64 (34.8%), Stage 3 - 61 (33.1%), and Stage 4 - 43 (23.4%). A majority of these patients (131, 71.2%) were neither hypoxic nor hypercapneic. Amongst the remaining 53 patients, 42 (22.8%) had hypoxia only; while the other 11 (6%) patients had hypercapnea also. Out of the 42 hypoxic patients, 13 were not using oxygen therapy at home. Two of the 11 patients with hypercapnea were not taking domiciliary BiPAP. Evaluation of cognitive status revealed that 43 (23.4%) had normal cognition, 53 (28.8%) had mild cognitive impairment, 54 (29.3%) had moderate cognitive decline, and 34 (18.5%) had severe cognitive defects.The worsening in both MMSE and TMT-A scores were found to be statistically significant with advancing age (most severe among the age group 61-70 years), smoking status, low level of education (primary school or less), severe and very severe COPD, hypoxia, and hypercapnea. Although we found a higher degree of cognitive impairment in males, this was not statistically significant. Cognition was normal in 70% of those with higher education (college and beyond). The impairment in cognition also correlated directly with the worsening of CAT scores in these patients.CONCLUSIONS: Adults with more severe COPD are at greater risk for developing cognitive impairment. Oxygen support helped in improving the cognitive status in hypoxic patients. However, usage of BiPAP support by hypercapneic patients did not significantly improve cognition.CLINICAL IMPLICATIONS: Cognitive dysfunction will make managing COPD more challenging, and will likely further worsen their general health and quality of life. Periodic screening of cognition should be done in all COPD patients, especially in those with hypoxia and hypercapnia.DISCLOSURES: No relevant relationships by Moonish AgarwalNo relevant relationships by Sudhir ChhabraNo relevant relationships by Chandramani PanjabiNo relevant relationships by Janardhan Singh SESSION TITLE: COPD Medications and Treatment Outcomes SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: COPD is now considered as a complex condition with numerous systemic components. Many neuropsychiatric disorders, viz. anxiety, depression and cognitive dysfunction, substantially contribute to COPD-related morbidity. The incidence of cognitive impairment in COPD varies from 10% to 61%, depending on the study population and the type of neuropsychological assessment. METHODS: We evaluated 184 stable COPD patients to establish a correlation between their cognitive dysfunctions and severity of COPD based on FEV1. Factors contributing to cognitive decline were also assessed. All patients were administered the COPD Assessment Test (CAT) questionnaire. For cognition, the Mini Mental State Examination (MMSE) and the Trail Making Test - Part A (TMT-A) were used. The MMSE questionnaire assesses orientation, recall and language, short-term memory, attention, and calculation. RESULTS: Approximately half (52.2%) of our patients were in the age group of 50-70 years, while 52 (28.3%) patients were more than 70 years. Three-quarters were males and the remaining one-fourth were females. The distribution of patients as per GOLD criteria was: Stage 1 - 16 (8.7%), Stage 2 - 64 (34.8%), Stage 3 - 61 (33.1%), and Stage 4 - 43 (23.4%). A majority of these patients (131, 71.2%) were neither hypoxic nor hypercapneic. Amongst the remaining 53 patients, 42 (22.8%) had hypoxia only; while the other 11 (6%) patients had hypercapnea also. Out of the 42 hypoxic patients, 13 were not using oxygen therapy at home. Two of the 11 patients with hypercapnea were not taking domiciliary BiPAP. Evaluation of cognitive status revealed that 43 (23.4%) had normal cognition, 53 (28.8%) had mild cognitive impairment, 54 (29.3%) had moderate cognitive decline, and 34 (18.5%) had severe cognitive defects. The worsening in both MMSE and TMT-A scores were found to be statistically significant with advancing age (most severe among the age group 61-70 years), smoking status, low level of education (primary school or less), severe and very severe COPD, hypoxia, and hypercapnea. Although we found a higher degree of cognitive impairment in males, this was not statistically significant. Cognition was normal in 70% of those with higher education (college and beyond). The impairment in cognition also correlated directly with the worsening of CAT scores in these patients. CONCLUSIONS: Adults with more severe COPD are at greater risk for developing cognitive impairment. Oxygen support helped in improving the cognitive status in hypoxic patients. However, usage of BiPAP support by hypercapneic patients did not significantly improve cognition. CLINICAL IMPLICATIONS: Cognitive dysfunction will make managing COPD more challenging, and will likely further worsen their general health and quality of life. Periodic screening of cognition should be done in all COPD patients, especially in those with hypoxia and hypercapnia. DISCLOSURES: No relevant relationships by Moonish Agarwal No relevant relationships by Sudhir Chhabra No relevant relationships by Chandramani Panjabi No relevant relationships by Janardhan Singh