Psychiatric Disorder and Quality of Life in Patients Awaiting Lung Transplantation *

Parekh, Priti I.; Blumenthal, James A.; Babyak, Michael A.; Merrill, Kari A.; Carney, Robert M.; Davis, Robert D.; Palmer, Scott M.

doi:10.1378/chest.124.5.1682

Cited by 74 publications

(53 citation statements)

References 22 publications

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“…The MoCA yields an overall cognitive assessment and valid subscores for the individual cognitive domains of visuospatial and executive function, naming, attention, language, abstraction (abstract reasoning), delayed recall (memory), and orientation. We examined cognition function as a continuous variable in our primary analysis and categorized cognitive impairment as mild (score of [18][19][20][21][22][23][24][25], moderate (10)(11)(12)(13)(14)(15)(16)(17), and severe (,10) in secondary analyses, with prior evidence suggesting that moderate to severe scores are similar to scores of patients with dementia (21-23; Z. Nasreddine, personal communication, July 2011). Mild cognitive impairment, as categorized based on the MoCA, is distinct from the diagnostic entity "Mild Cognitive Impairment" (9).…”

Section: Study Populationmentioning

confidence: 99%

“…Care that results in cognitive impairment may be less acceptable to patients than death (11). Cognitive and psychiatric impairments are common in patients with advanced lung disease before transplantation (12)(13)(14)(15)(16)(17)(18). Recent evidence suggests that cognition may further decline after lung transplantation (19), yet the frequency and determinants of cognitive impairment after lung transplantation remain largely unknown.…”

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confidence: 99%

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Cognitive Function, Mental Health, and Health-related Quality of Life after Lung Transplantation

Cohen

Christie²,

Anderson³

et al. 2014

Annals ATS

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Rationale: Cognitive and psychiatric impairments are threats to functional independence, general health, and quality of life. Evidence regarding these outcomes after lung transplantation is limited.Objectives: Determine the frequency of cognitive and psychiatric impairment after lung transplantation and identify potential factors associated with cognitive impairment after lung transplantation.Methods: In a retrospective cohort study, we assessed cognitive function, mental health, and health-related quality of life using a validated battery of standardized tests in 42 subjects posttransplantation. The battery assessed cognition, depression, anxiety, resilience, and post-traumatic stress disorder (PTSD). Cognitive function was assessed using the Montreal Cognitive Assessment, a validated screening test with a range of 0 to 30. We hypothesized that cognitive function post-transplantation would be associated with type of transplant, cardiopulmonary bypass, primary graft dysfunction, allograft ischemic time, and physical therapy posttransplantation. We used multivariable linear regression to examine the relationship between candidate risk factors and cognitive function post-transplantation.Measurements and Main Results: Mild cognitive impairment (score, 18-25) was observed in 67% of post-transplant subjects (95% confidence interval [CI]: 50-80%) and moderate cognitive impairment (score, 10-17) was observed in 5% (95% CI, 1-16%) of post-transplant subjects. Symptoms of moderate to severe anxiety and depression were observed in 21 and 3% of post-transplant subjects, respectively. No transplant recipients reported symptoms of PTSD. Higher resilience correlated with less psychological distress in the domains of depression (P , 0.001) and PTSD (P = 0.02). Prolonged graft ischemic time was independently associated with worse cognitive performance after lung transplantation (P = 0.001).The functional gain in 6-minute-walk distance achieved at the end of post-transplant physical rehabilitation (P = 0.04) was independently associated with improved cognitive performance post-transplantation.Conclusions: Mild cognitive impairment was present in the majority of patients after lung transplantation. Prolonged allograft ischemic time may be associated with cognitive impairment. Poor physical performance and cognitive impairment are linked, and physical rehabilitation post-transplant and psychological resilience may be protective against the development of long-term impairment. Further study is warranted to confirm these potential associations and to examine the trajectory of cognitive function after lung transplantation.Keywords: lung transplantation; cognitive function; psychological function; quality of life; critical illness

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Section: Study Populationmentioning

confidence: 99%

mentioning

confidence: 99%

Cognitive Function, Mental Health, and Health-related Quality of Life after Lung Transplantation

Cohen

Christie²,

Anderson³

et al. 2014

Annals ATS

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“…The presence of one or more dedicated caregivers is essential to ensuring patients' success with lung transplant, as patients initially are highly dependent on their caregivers for perioperative care. Furthermore, we have previously demonstrated that poor social support is significantly associated with psychiatric comorbidity among potential lung transplant recipients [3].…”

Section: Introductionmentioning

confidence: 99%

Emotional distress and quality of life in caregivers of patients awaiting lung transplant

Claar

Parekh

Palmer

et al. 2005

Journal of Psychosomatic Research

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“…2,3 Greater neuropsychiatric symptoms, including depression and anxiety, have been observed among lung transplant candidates, with as many as 25% of lung transplant patients meeting diagnostic criteria for a mood or anxiety disorder. 4 Several studies have also examined psychosocial factors as predictors of mortality among lung transplant patients. 5,6 Evon and colleagues 5 found that depression was associated with poorer wait-list survival among lung transplant candidates, but that this…”

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confidence: 99%

Neurobehavioral Functioning and Survival Following Lung Transplantation

Smith

Blumenthal

Carney

et al. 2014

Chest

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Background: Neurobehavioral functioning is widely recognized as being an important consideration in lung transplant candidates, but little is known about whether these factors are related to clinical outcomes. The present study examined the relationship of neurobehavioral functioning, including measures of executive function and memory, depression, and anxiety, to long-term survival among lung transplant recipients.

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Psychiatric Disorder and Quality of Life in Patients Awaiting Lung Transplantation *

Cited by 74 publications

References 22 publications

Cognitive Function, Mental Health, and Health-related Quality of Life after Lung Transplantation

Cognitive Function, Mental Health, and Health-related Quality of Life after Lung Transplantation

Emotional distress and quality of life in caregivers of patients awaiting lung transplant

Neurobehavioral Functioning and Survival Following Lung Transplantation

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