Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States and is the only leading cause that is increasing in prevalence. The economic and societal impact of COPD is immense with both direct and indirect costs estimated in recent years to be 26 billion dollars annually. The focus of treatment is on improving health status and preventing exacerbations through improved self-management. Self-management of COPD is founded on symptom management and is required for daily care professional. Cognitive processes are vital to determinations of symptom intensity and are the gateway to self-management for individuals with COPD where chronic dyspnea mandates medication use, assessment of function and care seeking. Cognitive processes define what is normal and typical for that individual and help to determine when an individual will maintain or increase self-management strategies or contact health care providers. Deterioration of cognitive processes, such as executive function and verbal memory is known to be associated with age, chronic illnesses and successful self-management with beginning evidence that these processes influence self reports of dyspnea. Consequently, the aim of this investigation is to examine the relationship of executive function and verbal memory to symptom self-management in individuals with COPD as indicated by: reports of symptom intensity (SI), medication use for SI, reports of activity limited address the following hypotheses and question: (1) Lower scores on measures of executive function and verbal memory will be found with greater severity of disease in COPD compared to what would be expected; (2) lower scores on executive function and/or verbal memory measures will predict greater SI; (3) Does the symptom self-management demonstrated by a) inconsistent reports of SI, b) medication use, c) activity limitation, or 3) care seeking events? The results will provide new insights into the role cognition plays in determining symptom intensity and care seeking.
