Does trail making test predict long-term prognosis in older patients with COPD?

Area of Science:

• Neuroscience
• Pulmonology
• Geriatrics

Background:

• Executive functions are often impaired in patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD).
• Cognitive deficits may impact disease progression and patient outcomes in COPD.
• The Trail Making Test (TMT) is a neuropsychological tool used to assess executive functions.

Purpose of the Study:

• To investigate the association between performance on the Trail Making Test (TMT) and overall mortality in stable COPD outpatients.
• To determine if specific TMT subtests, particularly TMT-B, can predict long-term survival in this patient population.

Main Methods:

• A cohort of 68 stable COPD outpatients was followed for an average of 52.6 months.
• Participants underwent a comprehensive baseline neuropsychological assessment, including TMT-A, TMT-B, and TMT-B minus A.
• Cox regression analysis was used to examine the relationship between neuropsychological test results and mortality, adjusting for confounders.

Main Results:

• During the follow-up period, 41 patients (60.3%) died.
• Defective performance on TMT-B was significantly associated with increased overall mortality (HR=2.42, 95% CI=1.10-5.31) after adjusting for age, comorbidity, and noninvasive ventilation use.
• Age, overall comorbidity, and use of noninvasive ventilation were also significant predictors of mortality.

Conclusions:

• Impaired performance on the Trail Making Test Part B (TMT-B) may serve as a significant predictor of long-term mortality in patients with stable COPD.
• Neuropsychological assessment, specifically TMT-B, could be a valuable tool for risk stratification in COPD management.
• Further research is warranted to explore the underlying mechanisms linking executive dysfunction to mortality in COPD.