Anna Croghan1,2, Amanda Brunette3, Kristen E Holm4,5, Elizabeth Kozora4,6, David J Moser2, Frederick S Wamboldt4,6, Kimberly Meschede4, Barry J Make4,7, James D Crapo4,7, Howard D Weinberger4,7, Kerrie L Moreau7,8, Russell P Bowler4,7, Karin F Hoth9. 1. Department of Psychology, University of North Dakota, Grand Forks, ND, USA. 2. Department of Psychiatry, University of Iowa Carver College of Medicine, 200 Hawkins Dr., W278GH, Iowa City, IA, 52242, USA. 3. Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA. 4. National Jewish Health, Department of Medicine, Denver, CO, USA. 5. Colorado School of Public Health, Department of Community and Behavioral Health, Aurora, CO, USA. 6. Department of Psychiatry, University of Colorado School of Medicine at the Anschutz Medical Campus, Aurora, CO, USA. 7. University of Colorado School of Medicine at the Anschutz Medical Campus, Aurora, CO, USA. 8. VA Eastern Colorado Geriatric Research, Education, and Clinical Center Aurora, Denver, CO, USA. 9. Department of Psychiatry, University of Iowa Carver College of Medicine, 200 Hawkins Dr., W278GH, Iowa City, IA, 52242, USA. karin-hoth@uiowa.edu.
Abstract
BACKGROUND: Attention difficulties are often reported by patients with chronic obstructive pulmonary disease (COPD); however, limited research exists using objective tests designed specifically to measure attention in this population. This study aimed to (1) identify specific attention deficits in COPD and (2) determine which demographic/clinical characteristics are associated with reduced attention. METHODS: Eighty-four former smokers (53 COPD, 31 no COPD) completed questionnaires, pulmonary function testing, and the Conner's Continuous Performance Test II (CPT-II). Participants with and without COPD were compared on CPT-II measures of inattention, impulsivity, and vigilance. CPT-II measures that differed significantly between the two groups were further examined using hierarchical regression modeling. Demographic/clinical characteristics were entered into models with attention as the dependent variable. RESULTS: Participants with COPD performed worse than those without COPD on CPT measures of inattention and impulsivity (i.e., detectability [discrimination of target from non-target stimuli], perseverations [reaction time under 100 ms], omissions [target stimuli response failures], and commissions [responses to non-target stimuli]). More severe COPD (measured by greater airflow limitation) was associated with poorer ability to detect targets vs. foils and perseverative responding after adjusting for age and other covariates in the model. CONCLUSION: Former smokers with COPD experience problems with attention that go beyond slowed processing speed, including aspects of inattention and impulsivity. Clinicians should be aware that greater airflow limitation and older age are associated with attention difficulties, as this may impact functioning.
BACKGROUND: Attention difficulties are often reported by patients with chronic obstructive pulmonary disease (COPD); however, limited research exists using objective tests designed specifically to measure attention in this population. This study aimed to (1) identify specific attention deficits in COPD and (2) determine which demographic/clinical characteristics are associated with reduced attention. METHODS: Eighty-four former smokers (53 COPD, 31 no COPD) completed questionnaires, pulmonary function testing, and the Conner's Continuous Performance Test II (CPT-II). Participants with and without COPD were compared on CPT-II measures of inattention, impulsivity, and vigilance. CPT-II measures that differed significantly between the two groups were further examined using hierarchical regression modeling. Demographic/clinical characteristics were entered into models with attention as the dependent variable. RESULTS:Participants with COPD performed worse than those without COPD on CPT measures of inattention and impulsivity (i.e., detectability [discrimination of target from non-target stimuli], perseverations [reaction time under 100 ms], omissions [target stimuli response failures], and commissions [responses to non-target stimuli]). More severe COPD (measured by greater airflow limitation) was associated with poorer ability to detect targets vs. foils and perseverative responding after adjusting for age and other covariates in the model. CONCLUSION: Former smokers with COPD experience problems with attention that go beyond slowed processing speed, including aspects of inattention and impulsivity. Clinicians should be aware that greater airflow limitation and older age are associated with attention difficulties, as this may impact functioning.
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