The Relationships Among Pulmonary Function, Aerobic Fitness, and Cognitive Functioning in Older COPD Patients: Materials and MethodsParticipants
Participants were 98 individuals who were taking part in the Reconditioning Exercise and COPD Trial (REACT). The REACT study is an 18-month exercise intervention in which all participants complete 3 months of exercise before being randomly assigned to either return to their normal lifestyle or to continue exercising for an additional 15 months. For the purposes of this study, only data from the initial screening visits were examined. Individuals with COPD were recruited from the community through physician referral, pamphlet distribution, and advertisements in local newspapers and on local television stations. To qualify for the study, participants had to be between the ages of 55 and 80 years. natural asthma inhalers

Additionally, they had to display an expiratory airflow limitation such that the ratio of FEV1 to FVC was < 70% and the FEV1 was > 20% of predicted. This expiratory airflow limitation could not be reversible by medication, with reversibility defined as > 12% and/or 200 mL improvement in the FEV1 after inhalation of 200 μg of albuterol via metered-dose inhaler using a cylindrical spacer device. Finally, participants also had to report difficulties in performing various activities of daily living due to dyspnea. Individuals were not allowed to participate if they had been involved in a regular exercise or pulmonary rehabilitation program during the preceding 6 months. A complete list of exclusion criteria is given in Table 1. Participants’ age, sex, and years of education were recorded by self report. Of the 98 participants, 34 reported that they were not taking any medications, 54 reported taking sympathomimetic bronchodila-tors, 27 reported taking anticholinergic bronchodilators, 33 reported taking steroidal anti-inflammatory agents, 25 reported taking diuretics, 24 reported taking calcium channel blockers, and < 20 reported taking any of the other categories of medications. Patients were asked to refrain from using inhaled or oral bronchodilators for 3 to 4 h prior to being tested.

Table 1—Exclusion Criteria

Criteria Characteristics That Would Result in Exclusion Screening Methods
Health Active treatment for cancer; severe congestive heart failure, stroke, peripheral vascular disease, coronary artery disease, valvular heart disease, major psychiatric disease, severe anemia, liver or renal disease, uncontrolled diabetes or hypertension, orthopedic impairment, blindness, or deafness History, physical examination, graded exercise test, personal physician
COPD with disability FEV/FVC > 70%, FEV: < 20% of predicted, or absence of reported disability, oxygen desaturation during exercise to < 90% at a heart rate < 50% of age predicted maximum without supplemental O2 Pulmonary function test, history, graded exercise test
Ability to comply with exercise interventions Inability to perform exercise due to physical disability or positive exercise stress test History, physical examination, graded exercise test
Alcohol use Consumption (current or within proceeding 2 mo) of > 2 drinks/d History
Inability to complete study Living > 50 miles from center or planning to move History