有和无 COPD 的戒烟者注意力降低。
Reduced Attention in Former Smokers with and without COPD.
机构信息
Department of Psychology, University of North Dakota, Grand Forks, ND, USA.
Department of Psychiatry, University of Iowa Carver College of Medicine, 200 Hawkins Dr., W278GH, Iowa City, IA, 52242, USA.
出版信息
Int J Behav Med. 2019 Dec;26(6):600-607. doi: 10.1007/s12529-019-09826-y.
BACKGROUND
Attention difficulties are often reported by patients with chronic obstructive pulmonary disease (COPD); however, limited research exists using objective tests designed specifically to measure attention in this population. This study aimed to (1) identify specific attention deficits in COPD and (2) determine which demographic/clinical characteristics are associated with reduced attention.
METHODS
Eighty-four former smokers (53 COPD, 31 no COPD) completed questionnaires, pulmonary function testing, and the Conner's Continuous Performance Test II (CPT-II). Participants with and without COPD were compared on CPT-II measures of inattention, impulsivity, and vigilance. CPT-II measures that differed significantly between the two groups were further examined using hierarchical regression modeling. Demographic/clinical characteristics were entered into models with attention as the dependent variable.
RESULTS
Participants with COPD performed worse than those without COPD on CPT measures of inattention and impulsivity (i.e., detectability [discrimination of target from non-target stimuli], perseverations [reaction time under 100 ms], omissions [target stimuli response failures], and commissions [responses to non-target stimuli]). More severe COPD (measured by greater airflow limitation) was associated with poorer ability to detect targets vs. foils and perseverative responding after adjusting for age and other covariates in the model.
CONCLUSION
Former smokers with COPD experience problems with attention that go beyond slowed processing speed, including aspects of inattention and impulsivity. Clinicians should be aware that greater airflow limitation and older age are associated with attention difficulties, as this may impact functioning.
背景
慢性阻塞性肺疾病（COPD）患者常报告注意力困难；然而，使用专门设计用于测量该人群注意力的客观测试进行的研究有限。本研究旨在：(1) 确定 COPD 患者的特定注意力缺陷；(2) 确定哪些人口统计学/临床特征与注意力下降有关。
方法
84 名前吸烟者（53 名 COPD，31 名非 COPD）完成了问卷、肺功能测试和康纳连续性能测试 II（CPT-II）。比较了 COPD 和非 COPD 患者在 CPT-II 注意力不集中、冲动和警觉方面的测量值。两组之间差异显著的 CPT-II 测量值使用分层回归模型进一步检查。将人口统计学/临床特征输入以注意力为因变量的模型中。
结果
与非 COPD 患者相比，COPD 患者在 CPT 注意力不集中和冲动（即可探测性[区分目标与非目标刺激]、持续[反应时间低于 100 毫秒]、遗漏[目标刺激反应失败]和错误[对非目标刺激的反应]）方面的表现更差。在调整模型中的年龄和其他协变量后，更严重的 COPD（通过更大的气流限制来衡量）与目标与干扰物的检测能力较差和持续反应有关。
结论
患有 COPD 的前吸烟者除了处理速度较慢外，还存在注意力问题，包括注意力不集中和冲动的方面。临床医生应该意识到，更大的气流限制和年龄较大与注意力困难有关，因为这可能会影响功能。
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