Skip to main content
SpringerLink
Log in

Evaluating Cognition in Patients with Chronic Obstructive Pulmonary Disease

  • Chapter
  • First Online:
Handbook on the Neuropsychology of Aging and Dementia

Part of the book series: Clinical Handbooks in Neuropsychology ((CHNEURO))

Abstract

In this chapter, we focus on the neuropsychological evaluation of patients with chronic obstructive pulmonary disease (COPD), a common adult pulmonary disorder characterized by restrictive airflow and respiratory distress. First, we will review the epidemiology and diagnostic criteria of COPD and of the most common medical comorbidities. Next, we will review the literature of cognition in patients with COPD and identify the most consistent neuropsychological deficits in the population. Multi­disciplinary rehabilitation is commonly prescribed for COPD patients. We will discuss the role of the neuropsychologist within the team. Finally, to more clearly illustrate the neuropsychological evaluation in patients with COPD, we will discuss a fictional case from our center with details regarding frequent referral questions, special considerations for the clinical interview, selection of cognitive tests, interpretation of tests, and final recommendations for the patient and/or the interdisciplinary rehabilitation team.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 269.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 349.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 499.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Shapiro SD, Reilly JJ, Rennard SI. Chronic bronchitis and emphysema. In: Mason RJ, editor. Murray and Nadel’s textbok of respiratory medicine. 5th ed. Philadelphia: WB Saunders; 2010.

    Google Scholar 

  2. Mannino DM, Homa DM, Akinbami LJ, Ford ES, et al. Chronic obstructive pulmonary disease ­surveillance—United States, 1971–2000. MMWR Surveill Summ. 2002;51(6):1–16.

    Google Scholar 

  3. Stockley RA, Mannino D, Barnes PJ. Burden and pathogenesis of chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2009;6(6):524–6.

    Article  PubMed  Google Scholar 

  4. Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007;370(9589):765–73.

    Article  PubMed  Google Scholar 

  5. Almagro P, Lopez Garcia F, Cabrera F, Montero L, et al. Comorbidity and gender-related differences in patients hospitalized for COPD. The ECCO study. Respir Med. 2010;104(2):253–9.

    Article  PubMed  Google Scholar 

  6. Fletcher CM, Elmes PC, Fairbairn AS, Wood CH. The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. Br Med J. 1959;2(5147):257–66.

    Article  PubMed  Google Scholar 

  7. Agusti A, Thomas A. Neff lecture. Chronic obstructive pulmonary disease: a systemic disease. Proc Am Thorac Soc. 2006;3(6):478–81.

    Article  PubMed  Google Scholar 

  8. Agusti A. Systemic effects of chronic obstructive pulmonary disease: what we know and what we don’t know (but should). Proc Am Thorac Soc. 2007;4(7):522–5.

    Article  PubMed  Google Scholar 

  9. Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004;23(6): 932–46.

    Article  PubMed  Google Scholar 

  10. Gan WQ, Man SF, Senthilselvan A, Sin DD. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax. 2004;59(7):574–80.

    Article  PubMed  Google Scholar 

  11. Boussuges A, Rossi P, Gouitaa M, Nussbaum E. Alterations in the peripheral circulation in COPD patients. Clin Physiol Funct Imaging. 2007;27(5): 284–90.

    Article  PubMed  Google Scholar 

  12. Han MK, McLaughlin VV, Criner GJ, Martinez FJ. Pulmonary diseases and the heart. Circulation. 2007;116(25):2992–3005.

    Article  PubMed  Google Scholar 

  13. Maclay JD, McAllister DA, Macnee W. Cardiovascular risk in chronic obstructive pulmonary disease. Respirology. 2007;12(5):634–41.

    Article  PubMed  Google Scholar 

  14. Mills NL, Miller JJ, Anand A, Robinson SD, et al. Increased arterial stiffness in patients with chronic obstructive pulmonary disease: a mechanism for increased cardiovascular risk. Thorax. 2008;63(4): 306–11.

    Article  PubMed  Google Scholar 

  15. Anthonisen NR, Connett JE, Enright PL, Manfreda J. Hospitalizations and mortality in the Lung Health Study. Am J Respir Crit Care Med. 2002;166(3): 333–9.

    Article  PubMed  Google Scholar 

  16. Dodd JW, Getov SV, Jones PW. Cognitive function in COPD. Eur Respir J. 2010;35(4):913–22.

    Article  PubMed  Google Scholar 

  17. Hynninen KM, Breitve MH, Wiborg AB, Pallesen S, et al. Psychological characteristics of patients with chronic obstructive pulmonary disease: a review. J Psychosom Res. 2005;59(6):429–43.

    Article  PubMed  Google Scholar 

  18. Agle DP, Baum GL. Psychological aspects of chronic obstructive pulmonary disease. Med Clin North Am. 1977;61(4):749–58.

    PubMed  Google Scholar 

  19. Norwood R. Prevalence and impact of depression in chronic obstructive pulmonary disease patients. Curr Opin Pulm Med. 2006;12(2):113–7.

    Article  PubMed  Google Scholar 

  20. Wamboldt FS. Anxiety and depression in COPD: a call (and need) for further research. COPD. 2005;2(2):199–201.

    Article  PubMed  Google Scholar 

  21. Weaver TE, Narsavage GL. Physiological and psychological variables related to functional status in chronic obstructive pulmonary disease. Nurs Res. 1992;41(5):286–91.

    Article  PubMed  Google Scholar 

  22. Gift AG, McCrone SH. Depression in patients with COPD. Heart Lung. 1993;22(4):289–97.

    PubMed  Google Scholar 

  23. van Ede L, Yzermans CJ, Brouwer HJ. Prevalence of depression in patients with chronic obstructive pulmonary disease: a systematic review. Thorax. 1999;54(8):688–92.

    Article  PubMed  Google Scholar 

  24. Aydin IO, Ulusahin A. Depression, anxiety comorbidity, and disability in tuberculosis and chronic obstructive pulmonary disease patients: applicability of GHQ-12. Gen Hosp Psychiatry. 2001;23(2):77–83.

    Article  PubMed  Google Scholar 

  25. Agle DP, Baum GL, Chester EH, Wendt M. Multidiscipline treatment of chronic pulmonary insufficiency. 1. Psychologic aspects of rehabilitation. Psychosom Med. 1973;35(1):41–9.

    PubMed  Google Scholar 

  26. Goodglass H, Kaplan E. The assessment of aphasia and related disorders. Philadelphia: Lea and Febiger; 1983.

    Google Scholar 

  27. Eiser N, Harte R, Spiros K, Phillips C, et al. Effect of treating depression on quality-of-life and exercise tolerance in severe COPD. COPD. 2005;2(2):233–41.

    Article  PubMed  Google Scholar 

  28. Kunik ME, Roundy K, Veazey C, Souchek J, et al. Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest. 2005;127(4): 1205–11.

    Article  PubMed  Google Scholar 

  29. Unutzer J, Patrick DL, Simon G, Grembowski D, et al. Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA. 1997;277(20): 1618–23.

    Article  PubMed  Google Scholar 

  30. Fix AJ, Golden CJ, Daughton D, Kass I, et al. Neuropsychological deficits among patients with chronic obstructive pulmonary disease. Int J Neurosci. 1982;16(2):99–105.

    Article  PubMed  Google Scholar 

  31. Grant I, Heaton RK, McSweeny AJ, Adams KM, et al. Neuropsychologic findings in hypoxemic chronic obstructive pulmonary disease. Arch Intern Med. 1982;142(8):1470–6.

    Article  PubMed  Google Scholar 

  32. Krop HD, Block AJ, Cohen E. Neuropsychologic effects of continuous oxygen therapy in COPD. Chest. 1973;64(3):317–22.

    Article  PubMed  Google Scholar 

  33. Prigatano GP, Parsons O, Wright E, Levin DC, et al. Neuropsychological test performance in mildly hypoxemic patients with chronic obstructive pulmonary disease. J Consult Clin Psychol. 1983;51(1):108–16.

    Article  PubMed  Google Scholar 

  34. Incalzi RA, Gemma A, Marra C, Muzzolon R, et al. Chronic obstructive pulmonary disease. An original model of cognitive decline. Am Rev Respir Dis. 1993;148(2):418–24.

    PubMed  Google Scholar 

  35. Stuss DT, Peterkin I, Guzman DA, Guzman C, et al. Chronic obstructive pulmonary disease: effects of hypoxia on neurological and neuropsychological measures. J Clin Exp Neuropsychol. 1997;19(4):515–24.

    Article  PubMed  Google Scholar 

  36. Ozge C, Ozge A, Unal O. Cognitive and functional deterioration in patients with severe COPD. Behav Neurol. 2006;17(2):121–30.

    PubMed  Google Scholar 

  37. Krop HD, Block AJ, Cohen E. Neuropsychological effects of continuous oxygen therapy in chronic obstructive pulmonary disease. Chest. 1977;64:317–22.

    Article  Google Scholar 

  38. Grant I, Prigatano GP, Heaton RK, McSweeny AJ, et al. Progressive neuropsychologic impairment and hypoxemia. Relationship in chronic obstructive pulmonary disease. Arch Gen Psychiatry. 1987;44(11): 999–1006.

    Article  PubMed  Google Scholar 

  39. Antonelli Incalzi R, Marra C, Giordano A, Calcagni ML, et al. Cognitive impairment in chronic obstructive pulmonary disease—a neuropsychological and spect study. J Neurol. 2003;250(3):325–32.

    Article  PubMed  Google Scholar 

  40. Liesker JJ, Postma DS, Beukema RJ, ten Hacken NH, et al. Cognitive performance in patients with COPD. Respir Med. 2004;98(4):351–6.

    Article  PubMed  Google Scholar 

  41. Kozora E, Filley CM, Julian LJ, Cullum CM. Cognitive functioning in patients with chronic obstructive pulmonary disease and mild hypoxemia compared with patients with mild Alzheimer disease and normal controls. Neuropsychiatry Neuropsychol Behav Neurol. 1999;12(3):178–83.

    PubMed  Google Scholar 

  42. Ortapamuk H, Naldoken S. Brain perfusion abnormalities in chronic obstructive pulmonary disease: comparison with cognitive impairment. Ann Nucl Med. 2006;20(2):99–106.

    Article  PubMed  Google Scholar 

  43. Toshima MT, Kaplan RM, Ries AL. Experimental evaluation of rehabilitation in chronic obstructive pulmonary disease: short-term effects on exercise endurance and health status. Health Psychol. 1990;9(3):237–52.

    Article  PubMed  Google Scholar 

  44. Emery CF, Leatherman NE, Burker EJ, MacIntyre NR. Psychological outcomes of a pulmonary rehabilitation program. Chest. 1991;100(3):613–7.

    Article  PubMed  Google Scholar 

  45. Kozora E, Tran ZV, Make B. Neurobehavioral improvement after brief rehabilitation in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2002;22(6):426–30.

    Article  PubMed  Google Scholar 

  46. Kozora E, Emery CF, Ellison MC, Wamboldt FS, et al. Improved neurobehavioral functioning in emphysema patients following lung volume reduction surgery compared with medical therapy. Chest. 2005;128(4):2653–63.

    Article  PubMed  Google Scholar 

  47. Kozora E, Emery CF, Zhang L, Make B. Improved neurobehavioral functioning in emphysema patients following medical therapy. J Cardiopulm Rehabil Prev. 2010;30(4):251–9.

    Google Scholar 

  48. Greene CC, Bradley KA, Bryson CL, Blough DK, et al. The association between alcohol consumption and risk of COPD exacerbation in a veteran population. Chest. 2008;134(4):761–7.

    Article  PubMed  Google Scholar 

  49. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.

    Article  PubMed  Google Scholar 

  50. Wechsler D. Wechsler adult intelligence scale—Fourth edition. San Antonio, TX: Pearson Education, Inc.; 2008.

    Google Scholar 

  51. Reitan RM, Wolfson D. The Halstead-Reitan neuropsychology test battery. Tucson: Neuropsychological Press; 1988.

    Google Scholar 

  52. Brandt J, Benedict RH. Hopkins Verbal Learning Test—Revised. Lultz, FL: Psychological Assessment Resources, Inc.; 1991.

    Google Scholar 

  53. Benedict RH. Brief Visuospatial Memory Test—Revised. Lutz, FL: Psychological Assessment Resources, Inc.; 1997.

    Google Scholar 

  54. Fastenau PS, Denburg NL, Mauer BA. Parallel short forms for the Boston Naming Test: psychometric properties and norms for older adults. J Clin Exp Neuropsychol. 1998;20(6):828–34.

    Article  PubMed  Google Scholar 

  55. Borkowski JG, Benton AL, Spreen O. Word fluency and brain damage. Neuropsychologia. 1967;5:135–40.

    Article  Google Scholar 

  56. Kozora E, Cullum CM. Qualitative features of clock drawings in normal aging and Alzheimer’s disease. Assessment. 1994;1(2):179–88.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Psychosocial Medicine, Department of Medicine, National Jewish Health, 1400 Jackson St., Room M107G, Denver, CO, 80206, USA

    Elizabeth Kozora Ph.D. & Karin F. Hoth Ph.D.

  2. Departments of Psychiatry and Neurology, University of Colorado Denver, Aurora, CO, USA

    Elizabeth Kozora Ph.D. & Karin F. Hoth Ph.D.

Authors
  1. Elizabeth Kozora Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karin F. Hoth Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elizabeth Kozora Ph.D. .

Editor information

Editors and Affiliations

  1. East 72 Street, STE 500 428, New York, 10021, New York, USA

    Lisa D. Ravdin

  2. Miller School of Medicine, University of Miami, NW. 14th Street 1120, Miami, 33136, Florida, USA

    Heather L. Katzen

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Kozora, E., Hoth, K.F. (2013). Evaluating Cognition in Patients with Chronic Obstructive Pulmonary Disease. In: Ravdin, L., Katzen, H. (eds) Handbook on the Neuropsychology of Aging and Dementia. Clinical Handbooks in Neuropsychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3106-0_28

Download citation

Publish with us

Policies and ethics

Search

Navigation