STUDY COPD may influence memory, experts say

A study begins this week to find out how COPD affects patients.
SCRIPPS HOWARD
Chronic bronchitis and emphysema sufferers might have more to worry about than coughing and wheezing.
The ailments -- part of the chronic obstructive pulmonary disease family -- might also cause memory problems, say two experts.
Paula Meek, a nursing professor at the University of New Mexico, and Kathie Insel, an assistant nursing professor at the University of Arizona, are starting a study this week to find out exactly how the family of diseases -- known as COPD for short -- affect patients.
"We don't know, but we think the diseases may have long-term implications for some COPDers, like accelerated aging," Meek said. "A patient with COPD might be 60 years old, but parts of their brain and memory function can look more like an 80-year-old."
Memory problems
The lung and respiratory diseases hurt the body's ability to get oxygen to the brain. That effect was studied in the 1980s, and oxygen treatments were added to patient care.
But the diseases might also cause carbon dioxide to build up in the blood stream, something that hasn't yet been studied, Insel said.
"That could also cause memory problems," she said. "The memory problems we're talking about aren't like Alzheimer's disease. They're more problems related to the processing of information in a person's short-term memory."
For example, remembering a seven-digit phone number in short-term memory wouldn't be a severe problem. But processing that number -- putting the digits in order from the smallest to largest -- might be increasingly difficult for people with the diseases, Insel said.
"What might be happening is that most of the time the patient's oxygen levels are fine, but a few times a week they might drop and rebound," Meek said. "That could cause the damage to parts of the brain that handle judgment and memory. Those parts of the brain are very sensitive to changes."
Double impact
If the diseases are causing such problems, it could have a double impact on patients. Not only could it damage memory, but it could also make it harder for them to get proper treatment, Meek said.
"People with COPD sometimes have problems remembering to take their medications and learning how to take them," she said. "A classic example is when someone comes into the office and you teach them how to use an inhaler. You might have to show them how to use it several times. They go home and come back a few weeks later, but they still don't know how to use it properly. They've forgotten."
If patients don't use their inhalers, bronchial tubes don't stay open as wide as they should, and that lessens the flow of oxygen to the brain, she said.
"First we're just trying to grab at exactly what COPDs are doing," Insel said. "That's what we'll be looking at in this study. After that, we might be able to help patients with new treatment strategies -- such as having them make lists that tell them exactly when they need to take their medicine or call a doctor."
If the study finds problems with carbon dioxide in the blood, it could also lead to more effective drug treatments in the future, Insel said.
The study is funded through a $750,000 grant from the National Institutes of Health Institute of Nursing Research.
Meek is looking for about 150 patients over age 40 with the diseases in the Albuquerque area to participate in the monthlong study. If they stay for the whole month, patients receive a $50 stipend.