Chronic obstructive pulmonary disease (COPD) is a severely debilitating illness with a profound negative impact on physical health and quality of life. COPD patients have been found to exhibit impairments in neuropsychological functioning, psychological well-being, and psychosocial functioning. Although several past studies have found improved physical endurance and psychological functioning among COPD patients following exercise rehabilitation, these studies have not utilized adequate control groups. Furthermore, no study to date has examined the effects of exercise rehabilitation on neuropsychological functioning of COPD patients. The proposed three studies are designed to examine the effects of both acute and chronic exercise on indicators of neuropsychological functioning among COPD patients. For the first study, 105 subjects with COPD will be randomly assigned to one of three groups: an exercise rehabilitation group, an education and social support control group, or a waiting list control group. Physiological functioning, neuropsychological functioning, psychological well-being, and psychosocial functioning will be assessed using standardized test instruments before and after a 10-week rehabilitation program. The third study will utilize a brief neuropsychological battery to examine the acute effects of exercise on neuropsychological functioning among 80 COPD patients in comparison to 80 sedentary, healthy older adults. It is hypothesized that exercise rehabilitation will be associated with significant gains in neuropsychological functioning and psychological well-being. The results of the initial study will have practical implications for planning and implementing rehabilitation programs for COPD patients, and will elucidate mechanisms of change in neuropsychological functioning and psychological well-being. The one-year follow-up study will indicate the efficacy of rehabilitation strategies for COPD patients, as well as the predictors of successful exercise rehabilitation outcomes. The third study will explore the extent to which cognitive deficits among COPD patients reflect disease processes versus normal human aging.
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