Mid-Term Effects of Pulmonary Rehabilitation on Cognitive Function in People with Severe Chronic Obstructive Pulmonary Disease.
Purpose
Cognitive dysfunction is a common impairment associated with COPD. However, little is known about 1) its prevalence among those subjects referred for pulmonary rehabilitation (PR), 2) how it may affect the benefit of PR, 3) whether PR improves cognitive function and 4) whether cognitive dysfunction affects the usability of telehealth technology usually used to deliver in-home PR.


Patients and Methods
﻿Fifty-six subjects with stable COPD (54% females, mean age 62 years (SD 9) and median FEV1 0.9 L (IQR 0.7 to 1.1)) participated in this multicenter observational study and performed 24 sessions of PR. The Montreal Cognitive Assessment ﻿tool (MoCA) was used to assess the occurrence of mild cognitive dysfunction (using a screening cutoff <26) at baseline, completion of PR and 3 months of follow-up.


Results
Mild cognitive dysfunction was found in 41 subjects (73% [95% CI: 60 to 83%]). The MoCA score significantly improved following PR for those people with baseline mild cognitive dysfunction (p<0.01). There was no significant difference in clinical outcomes between those people with or without mild cognitive dysfunction following PR nor in the proportion of subjects who were autonomous in using the telemonitoring system (83% compared with 71%, p=0.60).


Conclusion
Mild cognitive dysfunction is highly prevalent among those people with COPD referred for PR but does not affect the benefits of PR nor the usability of a telemonitoring system. PR may improve short- and mid-term cognitive function for those people who experience mild cognitive dysfunction at the time they are referred to PR.
['Bonnevie|Tristan|T|', 'Medrinal|Clement|C|0000-0003-3186-4891', 'Combret|Yann|Y|', 'Debeaumont|David|D|', 'Lamia|Bouchra|B|', 'Muir|Jean-François|JF|', 'Cuvelier|Antoine|A|0000-0003-0263-1845', 'Prieur|Guillaume|G|', 'Gravier|Francis-Edouard|FE|']
D000368:Aged D003071:Cognition D060825:Cognitive Dysfunction D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D029424:Pulmonary Disease, Chronic Obstructive D011795:Surveys and Questionnaires D016896:Treatment Outcome
pulmonary rehabilitation cognitive dysfunction COPD exercise