Relationship between cognition, disease severity and balance performance in individuals with Chronic Obstructive Pulmonary Disease
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Abstract
Background: Accumulating evidence reveals that balance and cognitive impairment often coexist in individuals with Chronic Obstructive Pulmonary Disease (COPD), particularly in severe stage of COPD. However, the correlations among the disease manifestations remain uncertain. Understanding the contribution of disease severity and cognition to balance may lead to an optimal clinical assessment and intervention in this population.
Objectives: To examine the correlations between disease severity, cognitive function and balance performance in individuals with COPD.
Materials and methods: Fifty individuals with COPD aged 40 years and over participated in this cross-sectional study. Disease severity was evaluated using spirometry and classified according to the Global Initiative for Obstructive Lung Disease (GOLD). Cognitive performance was measured using the Montreal Cognitive Assessment-Basic (MoCA-B) Thai version. Balance performance was assessed using the Timed Up and Go test (TUG) under single- and dual-task conditions.Pearson’s correlation coefficient was used to examine the relationship between the parameters evaluated. Independent sample student’s t-test was conducted to compare balance performance between participants with and without cognitive impairment. Significance level was set at 0.05 for all analyses.
Results: The time taken to complete TUG for both single- and dual-task conditions was negatively correlated with the MoCA-B score (TUG-single r = -0.47; TUG-dual r = -0.48; p≤0.001). There were no correlations between the time to complete TUG both conditions and %predictedFEV1. Subgroup analyses demonstrated that the cognitively-impaired group took significantly longer time to complete TUG for both conditions than the cognitively-intact group (p<0.01).
Conclusion: Balance performance significantly correlated with cognitive performance but not COPD severity. Cognitive impairment adversely affected balance ability and posed individuals with COPD at risk of falls. Balance and cognitive performances should be assessed in individuals with COPD regardless of the disease severity.
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Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
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