Risk factors of mild cognitive impairment in patients with chronic obstructive pulmonary disease and the effect of pulmonary rehabilitation training on cognitive improvement

PAN Chuli; SONG Shangdao; YU Xiaofeng

doi:10.13276/j.issn.2097-1656.2025.06.010

Abstract：Objective To analyze the risk factors of mild cognitive impairment(MCI)in patients with chronic obstructive pulmonary disease(COPD)and the effect of pulmonary rehabilitation training on improving patients' cognition.Methods A total of 122 COPD patients admitted to the Department of Respiratory and Critical Care Medicine,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua Municipal Central Hospital from April 2022 to April 2024 were divided into MCI group(n=58)and non-MCI group(n=64)according to whether they were complicated with MCI.The risk factors of COPD patients with MCI were analyzed by univariate analysis and multivariate logistic regression analysis.Patients were included in the experimental group(n=61)and the control group(n=61)by random number table method.The control group received conventional symptomatic treatment,and the experimental group was combined with pulmonary rehabilitation training on the basis of conventional symptomatic treatment.Both groups were treated for 12 weeks.The risk factors of COPD patients with MCI were analyzed by univariate and multivariate logistic analysis.Cardiopulmonary exercise function,blood gas analysis,cognition,disease progression and quality of life,and auditory event-related potential P300 test results were compared between the two groups before treatment and 12 weeks after treatment.Results Compared with the non-MCI group,the age of the MCI group ≥ 60 years old,the education level of junior high school or below,COPD course ≥5 years,family income per capita＜5 000 yuan,combined with hypertension,COPD disease classification grade Ⅲ,combined with negative emotions,and the number of acute attacks≥1 time/year in the past 2 years accounted for a higher proportion,and the difference was statistically significant(P＜0.05).Multivariate logistic analysis showed that age≥60 years,COPD course ≥ 5 years,COPD disease classification grade Ⅲ,combined with negative emotions,and the number of acute attacks ≥ 1 time/year in the past 2 years were risk factors for MCI in COPD patients(OR=2.140,2.264,2.083,1.902,2.149,P＜0.05).Compared with before treatment,after 12 weeks of treatment,6-min walking distance,maximum minute ventilation,peak oxygen uptake,arterial oxygen saturation,arterial oxygen partial pressure and Montreal Cognitive Assessment scores in both groups improved(P＜0.05),and the experimental group was higher(P＜0.01).Compared with before treatment,after 12 weeks of treatment,the scores of carbon dioxide ventilation equivalent,COPD Assessment Test and St.George's Respiratory Questionnaire decreased in both groups(P＜0.05),and the experimental group was lower(P＜0.01).Compared with before treatment,after 12 weeks of treatment,the amplitude of Pz in control group was increased(P＜0.05),the latency of Fz,Cz and Pz in experimental group was shortened,and the amplitude was increased(P＜0.05).The latency of Fz,Cz and Pz in experimental group was shorter than that in control group(P＜0.05).Conclusion There were many risk factors for MCI in COPD patients,and pulmonary rehabilitation training can improve auditory event-related potential P300 test results,cognitive function,cardiopulmonary exercise function,and blood gas analysis,control disease progression,and finally improve the quality of life of patients.