Attention, memory, and executive functioning in hypoxemic chronic obstructive pulmonary disease patients

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow obstruction and is one of the leading causes of death globally. The changes in pulmonary functions in COPD are irreversible with devastating consequences. Cognitive functioning in COPD patients is often found impaired and postulated to happen due to hypoxemia, i.e., oxygen deprivation to the brain. An impaired cognitive functioning can have direct impact on functional abilities as well as quality of life of patients and could be a vital treatment goal. The study aimed to explore the attention, memory, and executive functioning in hypoxemic COPD patients in backdrop of dearth of studies from India. Materials and Methods: Using purposive sampling, 30 patients with COPD, having mild-to-moderate level of illness severity, and having minimum illness for duration of 5 years were compared with 30 healthy controls. Participants were assessed for cognitive functioning in the domains of sustained attention, processing and psychomotor speed, working memory, verbal learning, and memory and executive functions using neuropsychological tests, namely, Digit Symbol Substitution Test, Trial Making Test, Verbal N Back Test, Rey's Audio Visual Learning Test, Controlled Oral Word Association Test, Animal Naming Test, Stroop Neuropsychological Test, and Modified Wisconsin Card Sorting Test. Results: Findings suggest significant differences between COPD patients and healthy controls over processing and psychomotor speed, working memory, memory, learning, and executive functioning. Conclusion: In addition to pulmonary distress, COPD patients also have compromised cognitive functions affecting overall daily functioning and quality of life. Understanding the nature of decline in cognitive functions could be vital in improving daily psychosocial functioning of the patients with COPD, and the exploration could help professionals in intervention of specific cognitive functioning.