Associations of cognition with physical functioning and health-related quality of life among COPD patients

Mark B. Schure, Soo Borson, Huong Q. Nguyen, Emily H. Trittschuh, Stephen M. Thielke, Kenneth C. Pike, Sandra G Adams, Vincent S. Fan

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)46-52
Number of pages7
JournalRespiratory Medicine
Volume114
DOIs
StatePublished - May 1 2016

Keywords

  • Affective symptoms
  • Cognition
  • COPD
  • Motor strength
  • Physical activity
  • Physical functioning
  • Quality of life

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Schure, M. B., Borson, S., Nguyen, H. Q., Trittschuh, E. H., Thielke, S. M., Pike, K. C., Adams, S. G., & Fan, V. S. (2016). Associations of cognition with physical functioning and health-related quality of life among COPD patients. Respiratory Medicine, 114, 46-52. https://doi.org/10.1016/j.rmed.2016.03.005