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The Proceedings of the American Thoracic Society 5:556-560 (2008)
© 2008 The American Thoracic Society
doi: 10.1513/pats.200708-123ET
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Cognitive and Psychological Issues in Emphysema

Elizabeth Kozora1,2, Charles Emery3, Robert M. Kaplan4, Fredrick S. Wamboldt1,2, Lening Zhang1 and Barry J. Make1,2

1 National Jewish Medical and Research Center and 2 University of Colorado Denver Health Sciences Center, Denver, Colorado; 3 Ohio State University, Columbus, Ohio; and 4 University of California, Los Angeles, Los Angeles, California

Correspondence and requests for reprints should be addressed to Elizabeth Kozora, Ph.D., 1400 Jackson Street, Denver, CO 80206. E-mail: kozorae{at}njc.org

ABSTRACT

Various psychological and cognitive difficulties have been documented in patients with emphysema. The aim of this article is to review prior literature on the prevalence of these difficulties in emphysema, as well as identify specific studies demonstrating improvement in these areas after therapy. Traditional therapies such as continuous and intermittent oxygen therapy and comprehensive pulmonary rehabilitation are reviewed. In general, these studies demonstrate reductions in symptoms of depression and anxiety as well as specific improvements in complex attention and verbal fluency. In a more recent study, patients with emphysema who underwent lung volume reduction surgery (LVRS) demonstrated improved psychomotor speed, verbal memory, and naming skills at 6 months compared with patients with emphysema who were in comprehensive rehabilitation only. The patients with emphysema who had LVRS also demonstrated greater decline in depressive symptoms compared with the rehabilitation patients at 6 months. There were no associations between improved neuropsychological tests and changes in depression, exercise tests, pulmonary function, oxygenation, or quality of life scores, and thus the mechanism of behavioral improvement identified in the patients who underwent LVRS remained unclear. Overall, studies suggest that psychological and cognitive improvements occur subsequent to a variety of medical and behavioral treatment therapeutic approaches, and that LVRS appears to have an advantage for some patients with emphysema.

Key Words: chronic obstructive pulmonary disease • lung volume reduction surgery • neurobehavioral


Related articles in Proceedings of the American Thoracic Society:

Health-related Quality of Life in Emphysema
Robert M. Kaplan and Andrew L. Ries
Proceedings of the American Thoracic Society 2008 5: 561-566. [Abstract] [Full Text]  





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