The Impact of Cognitive Impairment on Efficacy of Pulmonary Rehabilitation in Patients With COPD

被引:42
作者
Cleutjens, Fiona A. H. M. [1 ]
Spruit, Martijn A. [1 ,2 ]
Ponds, Rudolf W. H. M. [3 ]
Vanfleteren, Lowie E. G. W. [1 ]
Franssen, Frits M. E. [1 ]
Dijkstra, Jeanette B. [3 ]
Gijsen, Candy [1 ]
Wouters, Emiel F. M. [1 ,4 ]
Janssen, Daisy J. A. [1 ]
机构
[1] Ctr Expertise Chron Organ Failure, CIRO, Dept Res & Educ, Hornerheide 1, NL-6085 NM Horn, Netherlands
[2] Maastricht Univ, NUTRIM Sch Nutr & Translat Res Metab, Dept Resp Med, Med Ctr, Maastricht, Netherlands
[3] Maastricht UMC Sch Mental Hlth & Neurosci MHeNS, Dept Med Psychol, Maastricht, Netherlands
[4] Maastricht UMC, Dept Resp Med, Maastricht, Netherlands
关键词
COPD; cognitive impairment; pulmonary rehabilitation; patient-related outcomes; FIELD WALKING TESTS; OLDER-ADULTS; MEDICATION ADHERENCE; IMPORTANT DIFFERENCE; DISEASE; DEPRESSION; DEMENTIA; VALIDATION; PREDICTORS; OUTCOMES;
D O I
10.1016/j.jamda.2016.11.016
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objectives: To compare changes in pulmonary rehabilitation (PR) dropout and outcomes between chronic obstructive pulmonary disease (COPD) patients with and without cognitive impairment. Design: A cross-sectional observational study. Setting: Patients with COPD were recruited from a PR centre in the Netherlands. Participants: The study population consisted of 157 patients with clinically stable COPD who were referred for and completed PR. Measurements: A comprehensive neuropsychological examination before start of PR was administered. Changes from baseline to PR completion in functional exercise capacity [ 6-minute walk test (6MWT)], disease-specific health status [COPD Assessment Test (CAT) and St George's Respiratory Questionnaire-COPD specific (SGRQ-C)], psychological well-being [Hospital Anxiety and Depression Scale (HADS)], COPD-related knowledge, and their need for information [Lung Information Needs Questionnaire (LINQ)] were compared between patients with and without cognitive impairment using independent samples t tests or Mann-Whitney U tests. Results: Out of 157 patients with COPD [mean age 62.9 (9.4) years, forced expiratory volume in the first second 54.6% (22.9%) predicted], 24 patients (15.3%) did not complete PR. The dropout rate was worse in patients with cognitive impairment compared to those without cognitive impairment (23.3% and 10.3%, P = .03). Mean changes in PR outcomes after PR did not differ between completers with and without cognitive impairment. The proportion of patients with a clinically relevant improvement in 6MWT, CAT, SGRQ-C, HADS, and LINQ scores was comparable for patients with and without cognitive impairment. Conclusion: PR is an effective treatment for patients with COPD and cognitive impairment. Yet patients with cognitive impairment are at increased risk for not completing the PR program. (C) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
引用
收藏
页码:420 / 426
页数:7
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