Background Neurocognitive impairment has been described in COPD patients, but little is known about its relationship with physical functioning and health-related quality of life (HRQL) in this chronically ill patient group. Methods 301 stable COPD patients completed the Trail Making Test (TMT-A: Psychomotor speed and TMT-B: Executive control); 198 patients completed the Memory Impairment Screen (MIS). Standardization of TMT-A and TMT-B scores to a normative population yielded classifications of normal, borderline, or impaired cognitive status. Using multivariable regression, we examined the relationship between the TMT-A, TMT-B, and MIS with physical functioning (physical activity, 6-min walk test, and grip strength) and health-related quality of life (HRQL) measured with the Chronic Respiratory Questionnaire and the SF-36. Results Nearly 30% of patients had either borderline or impaired cognition on the TMT-A or TMT-B. Adjusted models indicated that those with either borderline or impaired cognitive functioning had weaker grip strength (TMT-A borderline: β = -2.9, P < 0.05; TMT-B borderline: β = -3.0, P < 0.05; TMT-B impaired: β = -2.5, P < 0.05) and lower scores on the mental health component summary score (MCS-SF-36 HRQOL) measure (TMT-A impaired: β = -4.7, P < 0.01). No adjusted significant associations were found for other physical functioning measures or the other HRQL measures. Impaired memory showed a significant association only with the MCS scale. Conclusions Cognitive function was not associated with most standard indicators of physical function or most measures of HRQL in COPD patients. Both TMT-A and TMT-B were associated with weaker grip strength, and the TMT-A and MIS with poorer mental health.
Bibliographical noteFunding Information:
This grant was funded by grant R01HL093146 from the National Heart, Lung, and Blood Institute (NHLBI). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the VA.
Mark Schure completed the study analyses and contributed to the manuscript development and, as lead author, takes primary responsibility for the integrity of the work. Soo Borson, Huong Nguyen, Emily Trittschuh, Stephen Thielke, and Vincent Fan provided content expertise and contributed to the manuscript development. Kenneth Pike provided statistical expertise, conducted and confirmed final analyses, and contributed to the manuscript development. Sandra Adams assisted with data quality and preparation and contributed to the manuscript development. This grant was funded by grant R01HL093146 from the National Heart, Lung, and Blood Institute (NHLBI) . Dr. Schure's work is supported by VA Postdoctoral Fellowship TPP 61-028 .
- Affective symptoms
- Motor strength
- Physical activity
- Physical functioning
- Quality of life