General cognitive impairment is highly prevalent in chronic obstructive pulmonary disease (COPD) patients. Domain-specific cognitive impairments include deficits in domains such as cognitive flexibility, verbal memory, working memory, planning, and psychomotor speed; which in general are associated with poor health behaviours, such as infrequent exercising and poor diet. Additional cognitive training may reverse these effects. Recent evidence suggests that working memory training is linked to self-control and, indirectly, to improved lifestyle behaviour including increased physical activity. The investigators hypothesise that enhancing cognitive performance through administering specific working memory training not only improves cognitive function but that it facilitates better adherence to a more active lifestyle and a healthier diet in COPD patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
QUADRUPLE
Enrollment
75
The working memory intervention training programme consists of a domain-general cognitive working memory training programme. One training session will take 20 to 30 minutes, and participants will have to complete approximately 40 cognitive training sessions. The sham treatment is the same as the intervention training however it does not increase in difficulty. Participants are presented with the same task at the same level of difficulty over and over again. Thus a training effect is not expected.
Participants will receive standardised healthy living coaching focusing on healthy diet and daily physical activity.
Maastricht University
Maastricht, Limburg, Netherlands
Feasibility of the cognitive training in COPD patients as measured through training compliance.
The compliance as well as the acceptability of working memory training in the COPD patient population will be investigated
Time frame: 6 months
Change in cognitive performance before and after working memory training as assessed through a cognitive test performance battery.
Improvement in cognitive flexibility, planning, and working memory.
Time frame: 6 months
Self-control (impulsivity)
This will be measured using the stop signal task.
Time frame: 6 months
Chronic stress levels as measured through hair levels of cortisol
An objective measure of stress levels experienced over the last 3 months will be measured using cortisol extracted from a hair sample.
Time frame: 6 months
Stress levels as measured through the salivary cortisol awakening response
An objective measure of stress will be measured using salivary cortisol awakening response
Time frame: 6 months
Stress perception as assessed through a perceived stress scale.
A subjective measure of chronic stress will be measured using the perceived stress scale score.
Time frame: 6 months
Acute stress as assessed through the socially evaluated cold pressor test
Acute stress will be measured using the socially evaluated cold pressor test, heart rate is also monitored.
Time frame: 6 months
Daily physical activity level
Physical activity data will be collected by an accelerometer using step counts.
Time frame: 6 months
Mental health, depressive symptoms assessed via the BDI-II
Mental health with respect to depression will be evaluated using the Beck Depression Inventory-second edition (BDI-II)
Time frame: 6 months
Mental health, anxiety symptoms assessed via the GAD-7
Mental health with respect to anxiety will be evaluated using the Generalised Anxiety Disorder 7 (GAD-7)
Time frame: 6 months
Physical performance assessed through the 6 minute walk test
Changes in physical performance will be assessed using the 6-minute walking test (6MWT).Two six-minute walk tests (6MWT) will be performed according to ERS/ATS guidelines to measure functional exercise capacity. The best 6MWT will be expressed in percentage of predicted values.
Time frame: 6 months
Self-determination questionnaire
Motivation will be prior to the enrolment of participants in this study in order to include patients who are motivated to initiate and continue our working memory training. The self-made questionnaire evaluates patient's reasons for participating in the study in order to assess their intrinsic motivation.
Time frame: 6 months
Short Performance Battery
The SPPB consists of three types of physical manoeuvres: the balance tests, the gait speed test, and the chair stand test. The results of the different tests result in a score which will be used for analysis.
Time frame: 6 months
Changes in dietary intake over the intervention period
Changes in dietary intake over the intervention period will be assessed using a food frequency questionnaire.
Time frame: 6 months
Medication adherence
Medication adherence will be measured using a sem
Time frame: 6 months
Regulation of Eating Behavior Scale (REBS)
Changes in eating behavior motivation will be investigated using the REBS.
Time frame: 6 months
Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2) Regulation
Changes in exercise motivation will be investigated using the BREQ-2
Time frame: 6 months
COPD Assessment test (CAT)
Impact of the intervention on quality of life will be done using the brief CAT questionnaire.
Time frame: 6 months
Anthropometry
Alterations in Anthropometical measures will be evaluated using waist circumference, biometric impedance, and body weight (BMI).
Time frame: 6 months
Manipulation Check
Participants will be asked to recall key health messages from their personalized healthy lifestyle advice sessions. Responses will be scored as follows: 0 points - field blank or no recall of the message content; 1 point - key points not directly related to the message themes; 2 points - key points directly related to the message themes.
Time frame: 6 months
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