Epidemiology of Dementia in Elderly Chronic Obstructive Pulmonary Disease Patients Living in China's Northwestern High-Elevation Area

• Published in: Medical science monitor Vol. 24; pp. 7742 - 7749
• Main Authors: Mei, Li, Wu, Shizheng, Wang, Dongchao, Li, Hezhou, Zhang, Hongmei, Wang, Min
• Format: Journal Article
• Language: English
• Published: United States International Scientific Literature, Inc 29.10.2018
• Subjects: Acetylcholinesterase - metabolism; Activities of Daily Living; Aged; Aged, 80 and over; Altitude; Asian Continental Ancestry Group - ethnology; China; Cholinesterase Inhibitors - therapeutic use; Clinical Research; Cognition Disorders - drug therapy; Cognitive Dysfunction - metabolism; Dementia - epidemiology; Donepezil - pharmacology; Female; Humans; Indans - therapeutic use; Longitudinal Studies; Male; Nootropic Agents - therapeutic use; Oxygen - metabolism; Oxygen - pharmacology; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - epidemiology; Retrospective Studies; China
• ISSN: 1643-3750; 1234-1010; 1643-3750
• DOI: 10.12659/msm.909501

BACKGROUND The aim of this study was to investigate the effects of oxygen and cholinesterase inhibitor (donepezil) therapy on dementia in patients with age-exacerbated chronic obstructive pulmonary disease (COPD) in China's northwestern high-altitude area. MATERIAL AND METHODS A total of 145 patients with acute exacerbation of COPD admitted to the Gerontology Department of the First People's Hospital of Xining City were initially retrospectively screened. From among these 145 patients, we selected 33 cases with dementia and 33 patients without dementia through use of the Mini-Mental State Examination (MMSE), the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and Activities of Daily Living (ADL) Scale evaluated before, 7 days after, and at the end of the treatment after 3 months. Both patient groups received oxygen therapy for 7 days, but patients with dementia in the intervention group were medicated additionally with donepezil (5 mg/day for 1 week, followed by 10 mg/day for another 12 weeks). RESULTS Mild dementia was found in 35 of the 145 COPD patients. ADL, MMSE, and ADAS-Cog scores were all significantly lower in the intervention group before treatment, improved after the first 7 days, and continued to improve significantly until week 12 in the intervention group, but were still significantly lower than in the control group. CONCLUSIONS Dementia in elderly COPD patients was mainly manifested as decreased executive function, attention, language, and delayed recall, while oxygen and donepezil therapy had beneficial effects on the symptoms.