IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 3 Ser. 10 (March. 2019), PP 53-65 www.iosrjournals.org DOI: 10.9790/0853-1803105365 www.iosrjournals.org 53 | Page Relationship between Cognitive Impairment and Socio- Demographic and Clinical Variables in COPD and Bronchial Asthma: A Comparative Study Dr.Mayank Sarawag 1 , Dr.Manju Bhaskar 2 1-Associate professor,Department of Medicine,Jhalawar Medical College,Jhalawar,Rajasthan. 2-Associate professor,Department of Psychiatry,Mahatma Gandhi Medical College and Hospital,Jaipur,Rajasthan. Corresponding Author: Dr.Manju Bhaskar Abstract: This is a cross sectional comparative case control study assessing the Relationship between cognitive impairment and socio demographic and clinical variables in chronic obstructive pulmonary disease (COPD) and Bronchial Asthma in comparison to healthy individuals. It is found that patients with COPD have significant cognitive deficits in comparison to patients with bronchial asthma.The cognitive impairment is related to to age , educationa ,occupation ,duration , severity of illness and steroid medication. Keywords: cognitive impairment, COPD, Bronchial Asthma, socio demographic, clinical variables --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 28-02-2019 Date of acceptance: 18-03-2019 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Cognitive dysfunction is associated with increased mortality and disability; however, it remains poorly understood in COPD. One review examined mechanisms of injury and dysfunction to the brain and considers the methods used to evaluate cognition, and assembles evidence concerning the nature and level of cognitive impairment in COPD. Main findings of this review were: 1) there may be a pattern of cognitive dysfunction specific to COPD; 2) cognitive function is only mildly impaired in patients without hypoxaemia; 3) the incidence of cognitive dysfunction is higher in hypoxaemia; 4) hypoxaemia, hypercapnia, smoking and comorbidities (such as vascular disease) are unlikely to account for all of the cognitive dysfunction seen in COPD; 5) there is weak or no association between cognitive function and mood, fatigue or health status; 6) cognitive dysfunction may be associated with increased mortality and disability; and 7) there is limited evidence for a significant effect of treatment on cognitive function. 1 Three groups of patients with COPD whose hypoxemia was mild (N = 86), moderate (N =155), or severe (N = 61) were compared with age- and education-matched nonpatients (N = 99). The rate of neuropsychologic deficit rose from 27% in mild hypoxemia to 61% in severe hypoxemia. Various neuropsychologic abilities declined at different rates, suggesting differential vulnerability of neuropsychologic functions to progress of COPD. Multivariate analyses revealed a consistent significant relationship between degree of hypoxemia and neuropsychologic impairment, but the amount of shared variance was small (7%). Increasing age and lower education were also associated with impairment. 2 Eighteen patients with chronic obstructive pulmonary disease (COPD) were administered a series of pulmonary, neurological, and neuropsychological measures to test if there was an effect of COPD on neurological and cognitive functioning. Overall, there was no evidence of general dementia in this sample. Measures of immediate and delayed memory, complex attention, and speed of information processing correlated highly with arterial carbon dioxide partial pressure and, to a lesser extent, with oxygen partial pressure. Measures of language abilities, perceptual-motor functioning, and simple attention generally were not related to arterial gas pressures. A similar pattern of findings was obtained when group differences were examined between participants classified as severely hypoxic or mildly hypoxic, although group differences were mitigated by premorbid IQ differences. And it was concluded that hypoxia in COPD results in a relatively focused pattern of impairment in measures of memory function and tasks requiring attention allocation. The memory dysfunction may be related to involvement of limbic memory regions necessary for explicit memory. The attentional deficits were attributed to diffuse brain involvement resulting in reduced resource allocation. Early diagnosis and treatment of the hypoxia is essential. 3 A study done by Inclazi et al to identify predictors of cognitive decline in patients with hypoxemic COPD on continuous oxygen therapy. And it was found that cognitive decline is faster in the presence of severe bronchial obstruction and parallels the worsening of the affective status in COPD patients on oxygen therapy.