Patients with interstitial lung diseases (ILDs) associate a large variety of comorbidities that have a significant impact on their clinical outcomes and survival. Among these comorbidities is neurological impairment. This review highlights what is known about the cognitive function, central nervous system (CNS), depression, and anxiety in patients with specific forms of fibrosing ILDs, such as idiopathic pulmonary fibrosis, sarcoidosis, hypersensitivity pneumonitis, connective tissue diseases, etc. The most common pathogenic mechanisms for neurocognitive dysfunction as well as the screening methods and tools for their identification are also described in this review.

Background and Objectives: Fibrosing interstitial lung diseases (ILDs) may predispose to neurocognitive impairment through chronic hypoxemia and systemic inflammation, yet data integrating pulmonary physiology, disease severity, and cognition are limited. We aimed to compare global cognitive performance between adults with fibrosing ILD and contemporaneous non-ILD clinic comparators, explore differences across ILD subtypes, and identify physiologic and clinical predictors of low MMSE scores. Materials and Methods: In this single-center cross-sectional study, 45 adults with fibrosing ILD and 32 non-ILD participants from university-affiliated pulmonology clinics completed the Mini-Mental State Examination (MMSE) and standardized lung function testing (including diffusing capacity, DLCO%). Comorbidity (Charlson index), inflammatory markers (C-reactive protein), and GAP (Gender–Age–Physiology) severity were recorded. Associations with MMSE and MMSE < 24 were examined using correlations and multivariable logistic regression. Results: Mean MMSE was lower in ILD than in non-ILD participants (23.9 ± 3.6 vs. 26.8 ± 2.8; p < 0.001), and MMSE < 24 occurred in 33.3% versus 12.5%, respectively. Within ILD, the usual interstitial pneumonia (UIP) pattern showed the lowest MMSE scores. DLCO% and total lung capacity correlated positively with MMSE (r = 0.44 and r = 0.34, respectively). In multivariable models, ILD diagnosis remained associated with MMSE < 24 (odds ratio [OR] 2.72, 95% CI 1.14–6.48), and each 10-percentage-point decrement in DLCO% increased the odds of MMSE < 24 (OR 1.42, 95% CI 1.11–1.92). GAP ≥ 4 was also associated with impaired cognition (OR 2.91, 95% CI 1.13–7.57). Conclusions: Fibrosing ILD, particularly with reduced diffusing capacity and higher GAP stage, is associated with lower MMSE scores and a higher frequency of values below a conventional impairment threshold. Prospective studies incorporating comprehensive neuropsychological testing are needed to determine whether and how neurocognitive assessment should be integrated into routine ILD care.

Background and Objectives: Interstitial lung diseases (ILDs) have been increasingly linked to neurological manifestations, including cognitive dysfunction and motor impairments, yet the prevalence and severity of these associations remain underexplored. We aimed to (1) compare the frequency of neurological symptoms between patients with and without ILD; (2) evaluate differences in cognitive and motor function scores; (3) perform subgroup analyses based on MoCA (Montreal Cognitive Assessment) scores; and (4) identify potential risk factors for neurological involvement. Methods: In this cross-sectional study, we enrolled 77 patients (40 with ILD and 37 without ILD). We recorded demographic data, smoking status, and body mass index (BMI). Neurological symptoms (tremor, diminished reflexes, paresthesia, etc.) were documented. Cognitive assessments included the MoCA and Symbol Digit Modalities Test (SDMT). Motor function was evaluated via the Berg Balance Scale (BBS), Timed Up and Go (TUG), Single-Leg Stance (SLS), and Grooved Pegboard Test (GPT). Results: Neurological symptoms were more prevalent in ILD (42.5%) than in non-ILD patients (16.2%; p = 0.003). Tremor appeared in 35% of ILD vs. 11% of non-ILD (p = 0.007). ILD patients showed lower mean SLS scores (7.2 ± 3.1 vs. 9.1 ± 3.8 s, p = 0.03) but similar TUG times (10.3 ± 2.1 vs. 9.6 ± 2.3 s, p = 0.20). MoCA scores < 26 were more common in those with ILDs (45% vs. 19%; p = 0.01). Among ILD participants, those with MoCA < 26 had significantly higher rates of tremor (51% vs. 24%, p = 0.04). Logistic regression revealed ILD diagnosis (OR = 3.12, 95% CI: 1.27–7.65, p = 0.013), older age (OR = 1.09 per year, p = 0.02), and smoking history (OR = 2.01, p = 0.05) as independent risk factors for neurological involvement. Conclusions: Our findings suggest that ILD is associated with a higher burden of neurological symptoms and subtle impairments in cognition and motor performance. Recognizing and addressing these manifestations may improve patient management, underscoring the importance of an integrative, multidisciplinary approach.