Neurological Symptom Frequency, Cognitive Dysfunction, and Motor Impairment in Patients with Interstitial Lung Disease: A Cross-Sectional Analysis

<b>Background and Objectives:</b> 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. <b>Methods:</b> 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). <b>Results:</b> Neurological symptoms were more prevalent in ILD (42.5%) than in non-ILD patients (16.2%; <i>p</i> = 0.003). Tremor appeared in 35% of ILD vs. 11% of non-ILD (<i>p</i> = 0.007). ILD patients showed lower mean SLS scores (7.2 ± 3.1 vs. 9.1 ± 3.8 s, <i>p</i> = 0.03) but similar TUG times (10.3 ± 2.1 vs. 9.6 ± 2.3 s, <i>p</i> = 0.20). MoCA scores < 26 were more common in those with ILDs (45% vs. 19%; <i>p</i> = 0.01). Among ILD participants, those with MoCA < 26 had significantly higher rates of tremor (51% vs. 24%, <i>p</i> = 0.04). Logistic regression revealed ILD diagnosis (OR = 3.12, 95% CI: 1.27-7.65, <i>p</i> = 0.013), older age (OR = 1.09 per year, <i>p</i> = 0.02), and smoking history (OR = 2.01, <i>p</i> = 0.05) as independent risk factors for neurological involvement. <b>Conclusions:</b> 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.