Executive Dysfunction Following Critical Illness: Exploring Risk Factors and Management Options in Geriatric Populations

Stollings, Joanna L.; Wilson, Jo Ellen; Jackson, James C.; Ely, E. Wesley

doi:10.1007/s40473-016-0076-3

Cited by 6 publications

(4 citation statements)

References 96 publications

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“…Is this dysexecutive/frontal syndrome characteristic of COVID-19 infection? Deficits in executive function are also prominent in patients with acute respiratory distress syndrome (ARDS) [104][105][106], and a significant percentage of ARDS survivors suffer long-term cognitive impairment with prominent dysexecutive traits [107], as part of PICS [106]. The major risk factors for the development of PICS are age, prior cognitive deficits, delirium, sepsis, sleep deprivation, ARDS, prolonged mechanical ventilation, and multiorgan failure [107][108][109], many of which are experienced by COVID-19 patients (Fig.…”

Section: Long-term Effects On Cognition and Cognitive Profilementioning

confidence: 99%

“…1). Mechanical ventilation has been associated with executive dysfunction during and after ICU treatment, and is a risk factor for developing delirium [105]. Nevertheless, not all COVID-19 patients who develop cognitive dysfunction in the aftermath have undergone mechanical ventilation, or have been in ICU, so this might be a causal agent as well as a cofactor.…”

Section: Long-term Effects On Cognition and Cognitive Profilementioning

confidence: 99%

See 1 more Smart Citation

Dementia and COVID-19, a Bidirectional Liaison: Risk Factors, Biomarkers, and Optimal Health Care

Toniolo

Scarioni

Lorenzo

et al. 2021

JAD

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Cognitive impairment following SARS-CoV-2 infection is being increasingly recognized as an acute and possibly also long-term sequela of the disease. Direct viral entry as well as systemic mechanisms such as cytokine storm are thought to contribute to neuroinflammation in these patients. Biomarkers of COVID-19-induced cognitive impairment are currently lacking, but there is some limited evidence that SARS-CoV-2 could preferentially target the frontal lobes, as suggested by behavioral and dysexecutive symptoms, fronto-temporal hypoperfusion on MRI, EEG slowing in frontal regions, and frontal hypometabolism on 18F-FDG-PET. Possible confounders include cognitive impairment due to hypoxia and mechanical ventilation and post-traumatic stress disorder. Conversely, patients already suffering from dementia, as well as their caregivers, have been greatly impacted by the disruption of their care caused by COVID-19. Patients with dementia have experienced worsening of cognitive, behavioral, and psychological symptoms, and the rate of COVID-19-related deaths is disproportionately high among cognitively impaired people. Multiple factors, such as difficulties in remembering and executing safeguarding procedures, age, comorbidities, residing in care homes, and poorer access to hospital standard of care play a role in the increased morbidity and mortality. Non-pharmacological interventions and new technologies have shown a potential for the management of patients with dementia, and for the support of their caregivers.

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Section: Long-term Effects On Cognition and Cognitive Profilementioning

confidence: 99%

Section: Long-term Effects On Cognition and Cognitive Profilementioning

confidence: 99%

Dementia and COVID-19, a Bidirectional Liaison: Risk Factors, Biomarkers, and Optimal Health Care

Toniolo

Scarioni

Lorenzo

et al. 2021

JAD

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“…Substantial metabolic deterioration has reportedly been noted in the cerebral cortex of patients with COPD, according to several investigations[ 51 , 52 ]. Given the potential impacts of long-term chronic hypoxia in COPD patients, frontal circuit elements are especially vulnerable to hypoperfusion and hypoxia[ 53 ]. In addition, studies have reported that post-PR, the cognitive ability of patients may not be improved comprehensively[ 10 , 21 , 54 ].…”

Section: Discussionmentioning

confidence: 99%

Exercise training influence on cognitive capacity and mental health within chronic obstructive pulmonary disease – A pilot study

Hong,

Shen,

Chang

et al. 2023

Tzu Chi Medical Journal

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Objective: Although pulmonary rehabilitation and regular exercise have improved negative emotions and cognitive capacity within cases of chronic obstructive pulmonary disease (COPD), influence by exercise training upon different cognitive and memory functions in COPD is still controversial. This investigation aimed to assess whether cognitive performance and mental health are affected by the benefits of exercise training within cases of COPD. Materials and Methods: This pilot investigation included thirty-three patients with Global Initiative for Chronic Obstructive Lung Disease stage ≥B. Based on the subjects’ rights, all included patients could choose to join either the exercise group or the control group, according to their free will. Twelve patients were assigned to receive exercise treatment over a 2-month period, while the remaining 16 patients were assigned to the control group. Cognitive capacity outcomes were measured using the Wechsler Memory Scale-III Word List Test, Stroop task, and psychomotor vigilance task (PVT). Mood states were assessed through the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Results: Most cases demonstrated major improvement for BDI and BAI scorings post-60-day therapy. During PVT, the omission rate decreased, while the hit rate increased, indicating an improvement in attention performance. Furthermore, this investigation found a significant increase in immediate verbal and recognition memory for word–list test. However, no major performance shifts were found on Stroop analysis. Conclusion: This investigation demonstrated that a 2-month exercise training program resulted in significant improvement in negative emotions, immediate memory, recognition memory, and attention.

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“…The majority of the literature concludes that several mechanisms such as hypoxemia, glucose dysregulation, and the effects of sedation contribute to development of neurological dysfunction. Studies regarding cognitive outcomes following critical illness report damage over a range of domains including attention, memory, processing speed, and executive function (52)(53)(54). A large cohort study of 821 patients in medical and surgical ICUs estimated a high risk of long-term cognitive impairment following critical illness (55).…”

Section: Cognitive Impairmentmentioning

confidence: 99%

Intensive Care Admission and Early Neuro-Rehabilitation. Lessons for COVID-19?

et al. 2020

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Coronavirus disease 2019 (COVID-19) requires admission to intensive care (ICU) for the management of acute respiratory distress syndrome in about 5% of cases. Although our understanding of COVID-19 is still incomplete, a growing body of evidence is indicating potential direct deleterious effects on the central and peripheral nervous systems. Indeed, complex and long-lasting physical, cognitive, and functional impairments have often been observed after COVID-19. Early (defined as during and immediately after ICU discharge) rehabilitative interventions are fundamental for reducing the neurological burden of a disease that already heavily affects lung function with pulmonary fibrosis as a possible long-term consequence. In addition, ameliorating neuromuscular weakness with early rehabilitation would improve the efficiency of respiratory function as respiratory muscle atrophy worsens lung capacity. This review briefly summarizes the polymorphic burden of COVID-19 and addresses possible early interventions that could minimize the neurological and systemic impact. In fact, the benefits of early multidisciplinary rehabilitation after an ICU stay have been shown to be advantageous in several clinical conditions making an early rehabilitative approach generalizable and desirable to physicians from a wide range of different specialties.

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Executive Dysfunction Following Critical Illness: Exploring Risk Factors and Management Options in Geriatric Populations

Cited by 6 publications

References 96 publications

Dementia and COVID-19, a Bidirectional Liaison: Risk Factors, Biomarkers, and Optimal Health Care

Dementia and COVID-19, a Bidirectional Liaison: Risk Factors, Biomarkers, and Optimal Health Care

Exercise training influence on cognitive capacity and mental health within chronic obstructive pulmonary disease – A pilot study

Intensive Care Admission and Early Neuro-Rehabilitation. Lessons for COVID-19?

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