Correlation between self-management, psychological cognitive impairment, and quality of life in elderly chronic obstructive pulmonary disease patients

BACKGROUND: The correlation conclusions between self-management, frailty, and quality of life (QoL) of chronic obstructive pulmonary disease (COPD) patients are inconsistent. AIM: To comprehensively assess the current status of self-management, psychological cognitive impairment, and QoL in elderly patients with COPD. METHODS: Convenient sampling was employed to select 312 elderly patients with COPD who were receiving treatment in the respiratory and critical care medicine department of a tertiary grade A hospital from November 2023 to February 2024. The study utilized demographic information and clinical characteristics, self-management behavior, occurrence of psychological cognitive impairment, and QoL as evaluated through general information questionnaires, the COPD patient self-management scale, simple frailty scale, simple mental status scale, clinical dementia assessment scale, and the clinical COPD assessment test questionnaire. This research aims to describe the current status and correlations among self-management behavior, cognitive impairment occurrence, and QoL. RESULTS: The average score for self-management behavior in elderly COPD patients was 136.00 (119.00, 164.50), indicating a moderate level overall. There were 98 cases of cognitive impairment, accounting for 31.4%, with a mental status score of 3 (2, 3.75). The average QoL score was 24 (19, 28), indicating a low level. Additionally, there was a negative correlation between total self-management behavior score and cognitive impairment occurrence (r = -0.589, P < 0.001), and QoL total score (r = -0.409, P < 0.001). Cognitive impairment occurrence was positively correlated with QoL total score (r = 0.345, P < 0.001). Disease course and self-management behavior score were independent factors affecting the total QoL score in elderly COPD patients (P < 0.05). CONCLUSION: The self-management behavior of elderly patients with COPD is at a moderate level. However, the occurrence of cognitive impairment is high and significantly influenced by disease course, level of self-management, and mental status. The QoL is low, emphasizing the urgent need to intervene in the self-management behaviors of elderly COPD patients, actively reduce the occurrence of cognitive impairment, and mitigate the impact of the disease on QoL.