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There is increasing evidence that survivors of ARDS may have impairments in cognitive function, mood and quality of life. This study investigated associations between cognitive impairment, mood disorders and quality of life in a select group of ARDS survivors.A cross-sectional study was conducted to describe the specific impairments in cognitive function, mood and quality of life in a group of 79 self-selected ARDS survivors who contacted an Internet-based support site. A battery of cognitive tests was administered by telephone interview. Standardized scores on cognitive tests were compared with normative values and tested for associations with indices of anxiety, depression and quality of life.Cognitive impairment was found in 56% of subjects. Compared with population norms, 24% of subjects had deficiencies in short-term memory (P = 0.04) and 29% in executive functioning (P = 0.001). Moderate or severe anxiety was present in 48% of the study population, and 34% had moderate or severe depression. Moderate or severe anxiety was present in 61% of subjects with evidence of cognitive impairment as compared with 31% of subjects without. Subjects with cognitive impairment scored worse than subjects without cognitive impairment on most subscales of the SF-36 and the Sickness Impact Profile questionnaire.Significant cognitive abnormalities may be present in long-term ARDS survivors, particularly in memory and executive function. Impairments in cognition appear to be associated with significantly increased anxiety and worse quality of life.