Neurocognitive correlates of functional impairment in COPD: the roles of sluggish cognitive tempo and cognitive flexibility

Meltem Hazel Şimşek; Selda Günaydın; Hayriye Bektaş Aksoy; Şaban Melih Şimşek

doi:10.38053/acmj.1896221

Neurocognitive correlates of functional impairment in COPD: the roles of sluggish cognitive tempo and cognitive flexibility

Abstract

Aims: The present study aims to examine differences in cognitive flexibility and sluggish cognitive tempo (SCT) levels in individuals diagnosed with Chronic obstructive pulmonary disease (COPD) according to disease stage and to evaluate the independent and indirect relationships of these cognitive processes on daily functioning. Methods: The cross-sectional study included 162 COPD patients classified according to GOLD 2024 criteria (GOLD A=46, GOLD B=55, GOLD E=61). Participants were administered the SCT Scale, Cognitive Flexibility Inventory (CFI), Hospital Anxiety and Depression Scale (HADS), COPD Assessment Test (CAT), and Functional Assessment Short Scale (FAST). Variables predicting daily functioning and SCT were examined using hierarchical regression analyses; mediating relationships were assessed using the PROCESS macro. Results: SCT levels were significantly higher in advanced COPD groups (p=0.015). In hierarchical regression, SCT was the strongest predictor of daily functioning (β=0.35, p<0.001). Symptom burden (CAT) was identified as a strong predictor of SCT (β=0.272, p<0.001), but lost significance when spirometric parameters were added to the model. Anxiety and depression scores were not found to be significant independent predictors in multivariate analysis (p>0.05). Simple mediation analysis showed that the effect of cognitive flexibility on functionality occurred through SCT (indirect effect=-0.179, 95% CI [-00.261, -0.105]). In the serial mediation model, the path CFI → CAT → SCT → FAST was found to be significant (indirect effect=-0.078, 95% CI [-0.140, -0.029]). Conclusion: In COPD, daily functioning is related more to symptom burden and especially SCT than to spirometric severity. Decreased cognitive flexibility may be associated with functional impairment through increased symptom perception and slowed cognitive tempo.

Keywords

References

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Details

Primary Language

English

Subjects

Chest Diseases, Psychiatry

Journal Section

Research Article

Authors

Meltem Hazel Şimşek ^*
0000-0002-3323-4116
Türkiye

Selda Günaydın
0000-0001-5641-012X
Türkiye

Hayriye Bektaş Aksoy
0000-0002-4390-5198
Türkiye

Şaban Melih Şimşek
0000-0002-2897-2421
Türkiye

Publication Date

May 22, 2026

Submission Date

February 23, 2026

Acceptance Date

March 20, 2026

Published in Issue

Year 2026 Volume: 8 Number: 3

DOI

https://doi.org/10.38053/acmj.1896221

IZ

https://izlik.org/JA76HH22MH

Cite

RIS / Bibtex

APA

Şimşek, M. H., Günaydın, S., Bektaş Aksoy, H., & Şimşek, Ş. M. (2026). Neurocognitive correlates of functional impairment in COPD: the roles of sluggish cognitive tempo and cognitive flexibility. Anatolian Current Medical Journal, 8(3), 401-408. https://doi.org/10.38053/acmj.1896221

AMA

1.Şimşek MH, Günaydın S, Bektaş Aksoy H, Şimşek ŞM. Neurocognitive correlates of functional impairment in COPD: the roles of sluggish cognitive tempo and cognitive flexibility. Anatolian Curr Med J / ACMJ / acmj. 2026;8(3):401-408. doi:10.38053/acmj.1896221

Chicago

Şimşek, Meltem Hazel, Selda Günaydın, Hayriye Bektaş Aksoy, and Şaban Melih Şimşek. 2026. “Neurocognitive Correlates of Functional Impairment in COPD: The Roles of Sluggish Cognitive Tempo and Cognitive Flexibility”. Anatolian Current Medical Journal 8 (3): 401-8. https://doi.org/10.38053/acmj.1896221.

EndNote

Şimşek MH, Günaydın S, Bektaş Aksoy H, Şimşek ŞM (May 1, 2026) Neurocognitive correlates of functional impairment in COPD: the roles of sluggish cognitive tempo and cognitive flexibility. Anatolian Current Medical Journal 8 3 401–408.

IEEE

[1]M. H. Şimşek, S. Günaydın, H. Bektaş Aksoy, and Ş. M. Şimşek, “Neurocognitive correlates of functional impairment in COPD: the roles of sluggish cognitive tempo and cognitive flexibility”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 3, pp. 401–408, May 2026, doi: 10.38053/acmj.1896221.

ISNAD

Şimşek, Meltem Hazel - Günaydın, Selda - Bektaş Aksoy, Hayriye - Şimşek, Şaban Melih. “Neurocognitive Correlates of Functional Impairment in COPD: The Roles of Sluggish Cognitive Tempo and Cognitive Flexibility”. Anatolian Current Medical Journal 8/3 (May 1, 2026): 401-408. https://doi.org/10.38053/acmj.1896221.

JAMA

1.Şimşek MH, Günaydın S, Bektaş Aksoy H, Şimşek ŞM. Neurocognitive correlates of functional impairment in COPD: the roles of sluggish cognitive tempo and cognitive flexibility. Anatolian Curr Med J / ACMJ / acmj. 2026;8:401–408.

MLA

Şimşek, Meltem Hazel, et al. “Neurocognitive Correlates of Functional Impairment in COPD: The Roles of Sluggish Cognitive Tempo and Cognitive Flexibility”. Anatolian Current Medical Journal, vol. 8, no. 3, May 2026, pp. 401-8, doi:10.38053/acmj.1896221.

Vancouver

1.Meltem Hazel Şimşek, Selda Günaydın, Hayriye Bektaş Aksoy, Şaban Melih Şimşek. Neurocognitive correlates of functional impairment in COPD: the roles of sluggish cognitive tempo and cognitive flexibility. Anatolian Curr Med J / ACMJ / acmj. 2026 May 1;8(3):401-8. doi:10.38053/acmj.1896221