Improvement of Cognitive Function After a Three-Month Pulmonary Rehabilitation Program for COPD Patients

Abstract

The objective of the study was to evaluate the effect of multidisciplinary pulmonary rehabilitation program on cognitive function in COPD patients, adjusting for potential confounders (gender, age, tobacco consumption, and educational level). In this prospective study, 34 COPD patients were submitted to neuropsychological testing before and after a 3-month pulmonary rehabilitation program. A control group with 18 healthy subjects of similar age, sex, and educational status was used to compare the cognitive function of COPD patients and healthy subjects at baseline. The association between the rehabilitation and change on th scores of cognitive variables, adjusted for each covariate, was estimated by means of linear random-intercept regression models. At baseline, the COPD patients had worse cognitive function with regard to verbal learning, memory, subjective organization, and verbal processing in comparison to the healthy volunteers. The improvement in cognitive performance by the COPD patients was evidenced even after adjusting for the sociodemographic factors that could potentially interfere on cognitive function. Male gender and age less than 65 years old were associated to higher scores in verbal learning and memory at baseline and after the rehabilitation program. The clinical approach to COPD-induced cognitive dysfunction should include participation in pulmonary rehabilitation programs. There were gender- and age-related differences in cognitive scores that persisted after rehabilitation.

Contribution of the Environment and Comorbidities to Chronic Obstructive Pulmonary Disease Phenotypes

“…97 The mechanisms behind cognitive dysfunction probably vary with each of these associations; some studies have demonstrated that participation in rehabilitation programs and the use of supplementary oxygen in patients with hypoxemia may decrease the risk of cognitive abnormalities. 94,98 …”

Evaluation of multidimensional COPD-related subjective fatigue following a Pulmonary Rehabilitation programme

“…Pulmonary rehabilitation (PR) is a well established gold standard of care for COPD patients, which improves patients' dyspnoea, QoL and exercise tolerance [11,12]. Recent studies have also shown that cognitive function [13], depression and anxiety [14,15] may improve with PR. One meta-analysis demonstrated significant improvement in the fatigue subscale of a QoL questionnaire after PR [16].…”

COPD is associated with cognitive dysfunction and poor physical fitness in heart failure

“…For instance, cardiac rehabilitation in HF patients has been shown to confer long-term improvements in attention/executive function and memory and such gains were suggested to involve increases in physical fitness [40]. Pulmonary rehabilitation has also been linked with cognitive benefits in multiple domains in patients with COPD [41]. Prospective studies are strongly encouraged to determine the most effective behavioral and medical interventions that may be able to reduce risk for poor neurocognitive outcomes in HF patients with and without COPD.…”