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Subjective cognitive complaints and neuropsychological performance in former smokers with and without chronic obstructive pulmonary disease
Authors:Amanda M Brunette  Kristen E Holm  Frederick S Wamboldt  Elizabeth Kozora  David J Moser  Barry J Make
Institution:1. Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA;2. Department of Medicine, National Jewish Health, Denver, CO, USA;3. Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA;4. Department of Psychiatry, University of Colorado School of Medicine at the Anschutz Medical Campus, Aurora, CO, USA;5. Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA;6. Department of Medicine, University of Colorado School of Medicine at the Anschutz Medical Campus, Aurora, CO, USA
Abstract:Objective: This study examined the association of perceived cognitive difficulties with objective cognitive performance in former smokers. We hypothesized that greater perceived cognitive difficulties would be associated with poorer performance on objective executive and memory tasks.

Method: Participants were 95 former smokers recruited from the COPDGene study. They completed questionnaires (including the Cognitive Difficulties Scale CDS] and the Hospital Anxiety and Depression Scale HADS]), neuropsychological assessment, and pulmonary function testing. Pearson correlations and t-tests were conducted to examine the bivariate association of the CDS (total score and subscales for attention/concentration, praxis, delayed recall, orientation for persons, temporal orientation, and prospective memory) with each domain of objective cognitive functioning (memory recall, executive functioning/processing speed, visuospatial processing, and language). Simultaneous multiple linear regression was used to further examine all statistically significant bivariate associations. The following covariates were included in all regression models: age, sex, pack-years, premorbid functioning (WRAT-IV Reading), HADS total score, and chronic obstructive pulmonary disease (COPD) status (yes/no based on GOLD criteria).

Results: In regression models, greater perceived cognitive difficulties overall (using CDS total score) were associated with poorer performance on executive functioning/processing speed tasks (b = ?0.07, SE = 0.03, p = .037). Greater perceived cognitive difficulties on the CDS praxis subscale were associated with poorer performance on executive functioning/processing speed tasks (b = ?3.65, SE = 1.25, p = .005), memory recall tasks (b = ?4.60, SE = 1.75, p = .010), and language tasks (b = ?3.89, SE = 1.39, p = .006).

Conclusions: Clinicians should be aware that cognitive complaints may be indicative of problems with the executive functioning/processing speed and memory of former smokers with and without COPD.
Keywords:Cognition  Cognitive Difficulties Scale  lung disease  neuropsychology  self-report
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