Gas exchange and exercise capacity affect neurocognitive performance in patients with lung disease.
OBJECTIVE
This study examined the relationship between cognitive functioning and the severity of underlying lung disease in patients awaiting lung transplantation.


METHODS
Ninety-four patients with end-stage lung disease completed a test battery to assess cognitive performance in two domains: executive functioning/attention (Trails A and B, COWA, Animal Naming, Stroop Color-Word Test, Digit Symbol, and the 2 & 7 Test) and verbal memory (Digit Span-Backward and Forward, WMS-R Logical Memory and Paired Verbal Associates).


RESULTS
Thirty-seven percent of the patients demonstrated moderate to severe cognitive impairment data on two or more tests. Adjusting for age and education, there were no statistically significant differences on executive functioning or verbal memory as a function of specific lung disease diagnosis. Lower PCO2 values were associated with better cognitive performance on latent measures of executive functioning and attention (p = .006) and verbal memory (p = .009), whereas higher PO2 values tended to be associated with better performance on the executive functioning/attention measure (p = .064). Distance walked in 6 minutes was positively related to verbal memory (p < .023).


CONCLUSIONS
Impaired neurocognitive functioning may be relatively common in patients awaiting lung transplantation and is associated with ineffective pulmonary gas exchange and reduced exercise tolerance.
Parekh
Priti I
PI
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Blumenthal
James A
JA
Babyak
Michael A
MA
LaCaille
Rick
R
Rowe
Sarah
S
Dancel
Liz
L
Carney
Robert M
RM
Davis
R Duane
RD
Palmer
Scott
S
D000328:Adult; D003071:Cognition / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D011300:Preoperative Care; D011581:Psychological Tests; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery; D012720:Severity of Illness Index