Abstract
Cognitive deficits influence the quality of life of Parkinson’s disease (PD) patients. In order to reduce the impact of cognitive impairment in PD, cognitive rehabilitation programs have been developed. This study presents a systematic review and meta-analysis regarding the effectiveness of cognitive rehabilitation in non-demented PD patients. Twelve articles were selected according to PRISMA guidelines. The systematic review showed that attention, working memory, verbal memory, executive functions and processing speed were the most frequently improved domains. Meta-analysis results showed moderate effects on global cognitive status (g = 0.55) and working memory (g = 0.50); small significant effects on verbal memory (g = 0.41), overall cognitive functions (g = 0.39) and executive functions (g = 0.30); small non-significant effects on attention (g = 0.36), visual memory (g = 0.29), verbal fluency (g = 0.27) and processing speed (g = 0.24); and no effect on visuospatial and visuoconstructive abilities (g = 0.17). Depressive symptoms showed small effect (g = 0.24) and quality of life showed no effect (g = −0.07). A meta-regression was performed to examine moderating variables of overall cognitive function effects, although moderators did not explain the heterogeneity of the improvement after cognitive rehabilitation. The findings suggest that cognitive rehabilitation may be beneficial in improving cognition in non-demented PD patients, although further studies are needed to obtain more robust effects.
Highlights
Parkinson’s disease (PD) is the second most common neurodegenerative disease afterAlzheimer’s disease [1]
Non-pharmacological interventions have been developed [9] with the aim of intervening on the cognitive and functional impairment of PD, with cognitive rehabilitation being one of the strategies suggested for personalized medicine [10]
Several systematic reviews [11,12,13,14,15,16] and meta-analyses [17,18,19] have reviewed and analyzed the effect of cognitive rehabilitation in PD, suggesting that this intervention may be potentially beneficial in increasing cognitive performance or maintaining cognitive levels over time, especially when treatment is applied before dementia has set in [12]
Summary
Parkinson’s disease (PD) is the second most common neurodegenerative disease afterAlzheimer’s disease [1]. Cognitive deficits are usually associated with PD [3], with 40% of PD patients developing mild cognitive impairment (MCI) during the course of the disease [4], and with attention, executive functions, visuospatial abilities and memory being the most affected domains [5,6]. The risk of dementia increases with the deterioration of cognitive deficits and disease progression [7], with 83% of PD patients with cognitive impairment presenting dementia after 20 years [8]. Non-pharmacological interventions have been developed [9] with the aim of intervening on the cognitive and functional impairment of PD, with cognitive rehabilitation being one of the strategies suggested for personalized medicine [10].
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