**5. Conclusion**

Patients with chronic respiratory conditions, such as obstructive sleep apnea, chronic obstructive pulmonary disease or idiopathic pulmonary fibrosis, commonly associate cognitive impairment. Neurologic assessment should be included in the routine diagnostic algorithm of these conditions, in order to appreciate the overall impact of the disease, on patient's quality of life and prognosis. Physicians who notice signs of memory loss, disorientation, gait impairment or even poor adherence to pharmacologic/nonpharmacologic treatment, should screen their patients for cognitive dysfunction. For a better outcome, subjects who are identified with mild cognitive impairment by a screening tool should be referred for a thorough evaluation to a neurologist, and the chronic lung disease management should be tailored according to individual's needs.

**35**

**Author details**

Emanuela Tudorache1

Timişoara, Romania

Pharmacy, Timişoara, Romania

provided the original work is properly cited.

\*, Monica Marc1

\*Address all correspondence to: tudorache\_emanuela@yahoo.com

1 Department of Pulmonology, "Victor Babes" University of Medicine and

2 Department of Radiology, "Victor Babes" University of Medicine and Pharmacy,

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

, Daniel Traila1

and Diana Manolescu2

*Cognitive Impairment in Chronic Lung Diseases DOI: http://dx.doi.org/10.5772/intechopen.91825*

*Cognitive Impairment in Chronic Lung Diseases DOI: http://dx.doi.org/10.5772/intechopen.91825*

*An Overview and Management of Multiple Chronic Conditions*

**4.3 Management of cognitive deficiency in IPF patients**

desaturation [91].

patients' lives.

**5. Conclusion**

tailored according to individual's needs.

A cross-sectional study aimed to assess cognition in IPF and to identify clinical cognition modifiers, and 23 IPF patients were evaluated using the Montreal Cognitive Assessment (MoCA) [66]. As it has been previously mentioned, MoCA is a screening instrument with high specificity and sensitivity for detecting early cognitive impairments and is validated in multiple settings and disorders. MoCA evaluates several cognitive domains (short-term memory, visuospatial abilities, executive functioning, attention, concentration and working memory, language, orientation to time and place) to differentiate healthy cognitive ageing from mild cognitive impairment [90]. The study found a mild cognitive impairment in patients with IPF that is related to the areas of visuospatial abilities, language and working memory. Obstructive sleep apnea was highly prevalent in these patients (more than 80% of cases), and there was a significant correlation between cognitive function and the severity of apnea hypopnea index. Poor sleep quality is frequently met in IPF through sleep breathing disorders, including OSA, implying increased sleep fragmentation, decreased slow wave and REM sleep, as well as sleep oxygen

Health-related quality of life is especially important in this patient population, given the lack of treatment options, poor mortality and rapid progression of the disease. The morbidity associated with IPF has a wide and profound impact on the patient's quality of life. Therefore, cognition level and other patient-centred outcomes are important goals to be evaluated in clinical research and practice. For IPF we do not currently have a specific cognitive assessment tool, so researchers have used validated tools in cognition analysis of other chronic respiratory diseases. The potential problem is that these tools cannot capture many of the effects of IPF on

Patients with chronic respiratory conditions, such as obstructive sleep apnea, chronic obstructive pulmonary disease or idiopathic pulmonary fibrosis, commonly associate cognitive impairment. Neurologic assessment should be included in the routine diagnostic algorithm of these conditions, in order to appreciate the overall impact of the disease, on patient's quality of life and prognosis. Physicians who notice signs of memory loss, disorientation, gait impairment or even poor adherence to pharmacologic/nonpharmacologic treatment, should screen their patients for cognitive dysfunction. For a better outcome, subjects who are identified with mild cognitive impairment by a screening tool should be referred for a thorough evaluation to a neurologist, and the chronic lung disease management should be

**34**
