Association of Chronic Obstructive Pulmonary Disease With Increased Confusion or Memory Loss and Functional Limitations Among Adults in 21 States, 2011 Behavioral Risk Factor Surveillance System

Abstract

IntroductionChronic obstructive pulmonary disease (COPD) is associated with cognitive impairment, but consequences of this association on a person’s functional limitations are unclear. We examined the association between COPD and increased confusion and memory loss (ICML) and functional limitations among adults with COPD. MethodsWe studied adults aged 45 years or older in 21 states who participated in the 2011 Behavioral Risk Factor Surveillance System (n = 102,739). Presence of COPD was based on self-reported physician diagnosis. ICML was based on self-report that confusion or memory loss occurred more often or worsened during the prior year. ICML-associated difficulties were defined as giving up household chores and former activities, decreased ability to work or engage in social activities, or needing help from family or friends during the prior year due to ICML. General limitations were defined as needing special equipment as a result of a health condition, having had activity limitations for 2 weeks or more in the prior month, or being unable to work. Multivariable models were adjusted for demographics, health behaviors or conditions, and frequent mental distress.ResultsCOPD was reported by 9.3% of adults. ICML was greater among those with COPD than among those without COPD (25.8% vs 11%; adjusted prevalence ratio [aPR], 1.48; 95% confidence interval [CI], 1.32%–1.66%). People with COPD, either with or without ICML, were more likely than those without COPD to report general functional limitations. Among people reporting ICML, those with COPD were more likely to report interference with work or social activities than those without COPD (aPR, 1.17; 95% CI, 1.01%–1.36%).ConclusionFunctional limitations were greater among those with COPD than among those without, and ICML may further affect these limitations. Results from our study can inform future studies of self- management and functional limitations for people with COPD.

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“…Furthermore, they underlined that socioeconomic status, smoking, pulmonary symptoms, and admission to hospital could have an effect on the adherence to inhalation therapy (Turan et al, 2017). Greenlund et al (2016) underlined that cognitive deficits, in particular confusion and memory loss, may affect functional limitations in COPD patients, increasing the need for assistance in different domains such as safety, transportation, house-hold activities, and personal care.…”

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“…Approximately 1.9 million United States (U.S.) residents of Central Appalachia are living with COPD, 1 a progressive respiratory condition that causes dyspnea (i.e., shortness of breath) which increases risks for physical immobility and emotional distress. [2][3][4][5] The highest quartile of COPD prevalence is concentrated in South Central Appalachia, one of the most disadvantaged regions in the U.S. 3 with states that have higher rural populations. 6,7 The Appalachian Region's COPD mortality rate (53.5 deaths per 100,000 population) is 27% higher than the national rate.…”

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“…A recent large study shows that 25% of patients reporting diagnosed COPD perceive memory deficits and related confusion, with the prevalence of functional limitations within this group that is higher than in general population. 38 …”

“… 27 Nonetheless, this group of patients more often than general population declares frequent mental distress. 38 Constraints of the airflow in general can cause emotional challenges, mainly from the anxiety–depression spectrum, and usually mild to severe disturbances are noted. 8 , 10 Most common problems include preclinical and psychiatric issues defined as fears, worries, low mood, apathy, lack of energy, depression, anxiety, panic attacks, and less often psychosis.…”