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Cognitive Improvement Following Rehabilitation in Patients With COPD*

Elizabeth Kozora, PhD; Barry J. Make, MD, FCCP
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*From the National Jewish Medical and Research Center, University of Colorado School of Medicine, Denver, CO.

Correspondence to: Elizabeth Kozora, PhD, National Jewish Medical and Research Center, University of Colorado School of Medicine, 1400 Jackson St, Denver, CO 80206



Chest. 2000;117(5_suppl_1):249S. doi:10.1378/chest.117.5_suppl_1.249S
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Abbreviations: BDI = Beck depression inventory

Thirty patients with COPD who completed 3 weeks of rehabilitation were evaluated before and after treatment on measures of cognition, depression, pulmonary function, and exercise capacity. These patients were compared to 29 untreated COPD patients and 21 healthy control subjects tested over a similar interval on these measures (including a 2-h neuropsychological assessment). Using analysis of covariance, significant group differences were found on the digit vigilance test (sustained visual attention, p = 0.006), visual retention (visual memory, p = 0.03) and semantic fluency (ability to generate words to a category, p = 0.04) scores. Post hoc pairwise comparisons found a greater improvement in the treated vs untreated COPD groups on digit vigilance and semantic fluency (p < 0.05). Additional results indicate that the treated COPD group significantly improved on the 6-min walk (mean, 265.6 feet) compared to the untreated COPD group (mean, 43.2 feet), and that this improvement was significantly correlated with improved digit vigilance scores (p = 0.03). Although the treated COPD group did not have a significant decline in depressive symptoms compared to the other groups on the Beck Depression Inventory (BDI), the change scores suggested a “clinical decline” in symptoms from the mildly distressed (mean BDI, 13.6) to the normal range (mean BDI, 8.3). Overall, these results indicate that changes in select cognitive functions and exercise capacity occur in COPD patients in rehabilitation compared to untreated COPD patients and healthy control subjects.

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