Inclusion Criteria:  Volunteering to participate in the study Stage 2-3-4 according to the GOLD classification in the 40-65 age range  Exclusion Criteria:  Exacerbation of respiratory symptoms in the past 4 weeks (change in breathlessness and/or sputum volume/color, need for antibiotic treatment or need for hospitalization) Presence of asthma, unstable coronary heart disease, uncontrolled diabetes, hypertension, left-sided congestive heart failure, neoplasia, severe claudication, encephalitis or epilepsy Having a history of head trauma or brain tumor Having a significant psychiatric condition or the presence of defined dementia, according to the American Psychiatric Association