Cognitive impairment in chronic obstructive pulmonary disease: disease burden, determinants and possible future interventions

Abstract

Introduction: Cognitive impairment (CI) is an important but an under-recognized extra-pulmonary feature of chronic obstructive pulmonary disease (COPD). It is related to the burden of disability, worse health outcomes, and impaired self-management. Areas covered: CI includes deterioration of a wide range of cognitive functions, such as memory and various executive functions. Risk of hospitalization might be higher in patients with COPD compared to those without, with CI negatively impacting the wellbeing of patients with COPD. Disease-specific factors such as hypoxemia and inflammation, lifestyle factors such as dietary insufficiencies and lack of physical activity, and comorbidities such as obstructive sleep apnea and depression are likely to synergistically contribute to the development of CI in COPD. Tailored interventions can possibly improve CI in COPD, but this needs further investigation. Expert commentary: Further research is warranted involving the optimization of neuropsychological testing for screening and outcome assessment, longitudinal studies to investigate the development of CI in COPD over time, and randomized clinical trials to test the feasibility and efficacy of promising interventions.

Changes in Spatial Working Memory in Stable Chronic Obstructive Pulmonary Disease: A Retrospective Study

“…As indicated above, COPD is a disease characterized by chronic hypoxia [4,[6][7][8][9], which will lead to brain hypoxia, including the PFC. Thus, we speculate that patients with COPD might also be with spatial working memory deficits because of this chronic hypoxia.…”

<p>Influencing Factors and Exercise Intervention of Cognitive Impairment in Elderly Patients with Chronic Obstructive Pulmonary Disease</p>

“…Cognition is a series of advanced activities in the cerebral cortex, including perception, storage, retrieval, and use of information; such activities enables individual behaviors to adapt to new situations and functions in the environment. 10 Cognitive function includes many independent areas, such as memory, attention, executive ability, feeling, perception, thinking, learning and judgment. 11 When one or more of the above mentioned functions are impaired and affect the individual's activities of daily life, the patient has cognitive impairment.…”

“…41 Furthermore, to improve the inflammation, patients with COPD often use bronchodilators such as long-acting β-adrenoceptor agonist and long-acting muscarinic antagonist, which can also inhibit the central nervous system and cause damage to the attention function of COPD patients. 10…”

ERS Scientific Working Group 09.04, “Psychologists and behavioural scientists”: the next step towards multidisciplinary respiratory care

“…Not surprisingly, people affected by chronic respiratory diseases show an increased risk of developing deficits in several cognitive functions (e.g. attention, mental flexibility, reasoning, memory and information processing speed) and developing mild cognitive impairment [41][42][43]. For example, a recent Dutch study demonstrated that of 183 people with COPD referred for pulmonary rehabilitation, 42% suffered from cognitive impairment as measured in a detailed neuropsychological test battery, and this prevalence was unrelated to the severity of COPD [44].…”