The role of structured exercise interventions on cognitive function in older individuals with stable Chronic Obstructive Pulmonary Disease: A scoping review.
Caroline C Eastus, Daniel E Baez, Maria L Buckley and 2 others
PMID 36386775WHAT IT FOUND
Structured exercise and pulmonary rehabilitation improved cognitive scores in older adults with COPD, especially those with existing impairment.
However, most programs combined exercise with education, so the benefit cannot be attributed to exercise alone. Clinical significance remains unclear.
Key findings
01Five studies involving 245 older adults with stable COPD showed improvements in various cognitive domains after exercise or pulmonary rehabilitation.
02Gains were consistently larger for participants who had cognitive impairment at baseline compared to those with normal cognition.
03The clinical importance of these score changes is unknown because reliable change thresholds for COPD patients have not been established.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only five studies were included, four of which were observational, limiting the strength of the evidence. The review did not perform a formal methodological quality assessment of the included studies. Interventions were heterogeneous: four used multidisciplinary pulmonary rehabilitation (mixing exercise with education and psychosocial support), making it impossible to isolate the effect of exercise alone. Cognitive tests varied across studies, and there is no established minimal clinically important difference for these tests in the COPD population, so it is unclear if the improvements matter to patients. The search was limited to English-language publications from 2010 to 2021, potentially missing relevant studies.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret these cognitive improvements as proof that exercise alone causes them. Most studies used multidisciplinary pulmonary rehabilitation, which includes education and psychosocial support, so the specific contribution of exercise cannot be separated. Additionally, the score changes may not represent clinically meaningful improvements for patients.