Computerized screening for cognitive impairment in patients with COPD

Abstract

Purpose

COPD is associated with cognitive impairment. These impairments should be diagnosed, but due to time- and budget-reasons, they are often not investigated. The aim of this study is to examine the viability of a brief computerized cognitive test battery, Central Nervous System Vital Signs (CNSVS), in COPD patients.

Patients and methods

Patients with COPD referred to tertiary pulmonary rehabilitation were included. Cognitive functioning of patients was assessed with CNSVS before pulmonary rehabilitation and compared with age-corrected CNSVS norms. CNSVS is a 30 minute computerized test battery that includes tests of verbal and visual memory, psychomotor speed, processing speed, cognitive flexibility, complex attention, executive functioning, and reaction time.

Results

CNSVS was fully completed by 205 (93.2%, 105 females, 100 males) of the total group of patients (n=220, 116 females, 104 males). Z-tests showed that COPD patients performed significantly worse than the norms on all CNSVS cognitive domains. Slightly more than half of the patients (51.8%) had impaired functioning on 1 or more cognitive domains. Patients without computer experience performed significantly worse on CNSVS than patients using the computer frequently.

Conclusion

The completion rate of CNSVS was high and cognitive dysfunctions measured with this screening were similar to the results found in prior research, including paper and pen cognitive tests. These results support the viability of this brief computerized cognitive screening in COPD patients, that may lead to better care for these patients. Cognitive performance of patients with little computer experience should be interpreted carefully. Future research on this issue is needed.

Keywords:

• CNS vital signs
• cognitive function
• computerized cognitive testing
• neuropsychological assessment
• viability

Acknowledgments

The authors thank all the patients for their effort to participate in this study. In addition, we thank the Schoondonck staff for their effort in recruiting patients for this study and scheduling the neuropsychological assessments. We thank Dr Karin Gehring for comments on an earlier version of the manuscript and Dr Wilco Emons for his statistical advice, and the research assistants for their help with the neuropsychological assessments.

Disclosure

The authors report no conflicts of interest in this work.