Benefits of pulmonary rehabilitation in COPD patients with mild cognitive impairment – A pilot study

Vasileios Andrianopoulos*, Rainer Gloeckl, Tessa Schneeberger, Inga Jarosh, Ioannis Vogiatzis, Emily Hume, Rembert A. Koczulla, Klaus Kenn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background:
Cognitive impairment might interfere with the efficacy of Pulmonary Rehabilitation (PR) in Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify differential responses to PR between cognitively impaired (CI) and cognitively normal (CN) COPD patients by assessing health status and exercise capacity.

Methods:
Sixty patients (FEV1: 47 ± 15%) were classified as CI or CN according to the Montreal Cognitive Assessment (MoCA ≤25points) and completed a 3-week inpatient PR program. Cognitive function (neuropsychological battery), health-status (36-Item Short Form Survey [SF-36]), and exercise capacity (6-min walk test [6MWT], cycle-endurance test [CET]) were assessed before and after PR. Responsiveness to PR was estimated by mean change (delta-value [Δ]) and the d-Effect Size (ES).

Results:
Twenty-five COPD patients (42%) presented evidence of mild CI prior to PR. Both, CI and CN patients significantly improved global cognitive function, health status (the majority of SF-36 components), and exercise capacity (6MWT and cycle endurance) in response to PR. Compared to CN, CI patients did not improve SF-36 subdomains of “role emotional” and “bodily pain”, and demonstrated a lower magnitude of improvement in 6MWT ([Δ]: 25 m; ES: 0.21) compared to CN ([Δ]: 46 m; ES: 0.54).

Conclusions:
PR has favorable effects on global cognitive function, health status, and exercise capacity in both CI and CN COPD patients. There was no concrete evidence to indicate interference of cognitive impairment to PR effectiveness.

Original languageEnglish
Article number106478
Number of pages9
JournalRespiratory Medicine
Volume185
Early online date23 May 2021
DOIs
Publication statusPublished - 1 Aug 2021

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