Neuropsychological dysfunction in patients suffering from end-stage chronic obstructive pulmonary disease

Abstract

Few studies have examined the neuropsychological sequelae associated with end-stage pulmonary disease. Neuropsychological data are presented for 47 patients with end-stage chronic obstructive pulmonary disease (COPD) who were being evaluated as potential candidates for lung transplantation. Although patients exhibited a diversity of neurocognitive deficits, their highest frequencies of impairment were found on the Selective Reminding Test (SRT). Specifically, over 50% of the patients completing the SRT exhibited impaired immediate free recall and consistent long-term retrieval deficits, while more than 44% of these individuals displayed deficient long-term retrieval. Deficient SRT long-term storage strategies, cued recall, and delayed recall were exhibited by between 26% and 35% of these patients, while more than 32% of this sample displayed elevated numbers of intrusion errors. Over 31% of the patients completing the Wisconsin Card Sorting Test (WCST) failed to achieve the expected number of categories on this measure, while more than 23% of these individuals demonstrated elevated numbers of perseverative errors and total errors. Clinically notable frequencies of impairment (greater than 20% of the sample) were also found on the Trail Making Test (TMT): Part B and the Wechsler Memory Scale-R (WMS-R) Visual Reproduction II subtest. Minnesota Multiphasic Personality Inventory-2 (MMPI-2) personality assessments indicated that patients were experiencing a diversity of somatic complaints and that they may have been functioning at a reduced level of efficiency. These findings are discussed in light of patients' endstage COPD and factors possibly contributing to their neuropsychological test performances. Implications for clinical practice and future research are also included.

Nonpharmacological treatment and relief of symptoms in COPD

“…After discharge, their cognitive status may improve to levels similar to those of stable COPD patients on LTOT [153]. In one study, more than half of the end-stage COPD patient candidates for lung transplantation suffered from impaired immediate free recall and consistent long-term retrieval deficits, whereas fewer of these patients suffered from deficient long-term retrieval [154].…”

Effects of Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea on Cognitive Functions: Evidence for a Common Nature

“…Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by the presence of airflow obstruction secondary to emphysema or chronic bronchitis [9]. COPD does not cause a fully reversible airway limitation due to chronic inflammatory process in the pulmonary tissue that often results in breathlessness for the patients, cough [10, 11], and excessive mucus production [12, 13].…”

Immediate and Long-term Neurocognitive Outcome in Patients with Obstructive Sleep Apnea Syndrome After Continuous Positive Airway Pressure Treatment

“…We excluded patients who had apnea-hypopnea index less than 30/h and who ever received oral appliance, surgical and CPAP treatment for OSAS. We also excluded subjects who had major medical disease because of these patients may have cognitive impairment, such as heart failure, chronic renal failure, liver cirrhosis, chronic obstructive pulmonary disease, hematological disease, autoimmune disease and cancer [12][13][14][15][16][17][18]. Patients with sleep disorder other than OSAS such as restless legs syndrome and periodic limb movements, neurological disorder, dementia, major psychiatric disorder, handicap, psychomotor retardation and had current use of any psychoactive or hypnotic medications were also excluded.…”