Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s disease
Background Approximately 60% to 80% of people with Parkinson's disease (PD) experience cognitive impairment that impacts on their quality of life. Cognitive decline is a core feature of the disease and can often present before the onset of motor symptoms. Cognitive training may be a useful non‐...
Gespeichert in:
| Veröffentlicht in: | Cochrane database of systematic reviews 2020-02, Vol.2020 (2), p.CD011961 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 2 |
| container_start_page | CD011961 |
| container_title | Cochrane database of systematic reviews |
| container_volume | 2020 |
| creator | Orgeta, Vasiliki McDonald, Kathryn R Poliakoff, Ellen Hindle, John Vincent Clare, Linda Leroi, Iracema Orgeta, Vasiliki |
| description | Background
Approximately 60% to 80% of people with Parkinson's disease (PD) experience cognitive impairment that impacts on their quality of life. Cognitive decline is a core feature of the disease and can often present before the onset of motor symptoms. Cognitive training may be a useful non‐pharmacological intervention that could help to maintain or improve cognition and quality of life for people with PD dementia (PDD) or PD‐related mild cognitive impairment (PD‐MCI).
Objectives
To determine whether cognitive training (targeting single or multiple domains) improves cognition in people with PDD and PD‐MCI or other clearly defined forms of cognitive impairment in people with PD.
Search methods
We searched the Cochrane Dementia and Cognitive Improvement Group Trials Register (8 August 2019), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and PsycINFO. We searched reference lists and trial registers, searched relevant reviews in the area and conference proceedings. We also contacted experts for clarifications on data and ongoing trials.
Selection criteria
We included randomised controlled trials where the participants had PDD or PD‐MCI, and where the intervention was intended to train general or specific areas of cognitive function, targeting either a single domain or multiple domains of cognition, and was compared to a control condition. Multicomponent interventions that also included motor or other elements were considered eligible.
Data collection and analysis
Two review authors independently screened titles, s, and full‐text articles for inclusion in the review. Two review authors also independently undertook extraction of data and assessment of methodological quality. We used GRADE methods to assess the overall quality of the evidence.
Main results
Seven studies with a total of 225 participants met the inclusion criteria for this review. All seven studies compared the effects of a cognitive training intervention to a control intervention at the end of treatment periods lasting four to eight weeks. Six studies included people with PD living in the community. These six studies recruited people with single‐domain (executive) or multiple‐domain mild cognitive impairment in PD. Four of these studies identified participants with MCI using established diagnostic criteria, and two included both people with PD‐MCI and people with PD who were not cognitively impaired. One study recruited people with a diagnosis of PD deme |
| doi_str_mv | 10.1002/14651858.CD011961.pub2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7043362</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2366636080</sourcerecordid><originalsourceid>FETCH-LOGICAL-p2552-6c538cf89228d511108f7bd6d6ccefeea7c8515cf09f43907fb0e5b87f4ee3543</originalsourceid><addsrcrecordid>eNpVUctOHDEQtKKgQEh-AfmYy2z8GHs8F6RkCQ8JCQ4g5WZ57fbiMGMv9uxG3PgNfi9fwkxgEZy6W1Vd1epC6ICSGSWEfae1FFQJNZsfEUpbSWer9YJ9QHsTUE3Ix_99W9Ut_72LPpfyhxAuW9Z8QrucUUIlb_eQm6dlDEPYAB6yCTHEJQ5xgLyBOIQUC_YpYwf9NBpsosN96By2r2uhX5mQJ3xcxJcm34ZYUvz38FiwCwVMgS9ox5uuwNeXuo-uj39dzU-r84uTs_mP82rFhGCVtIIr61XLmHKCUkqUbxZOOmkteADTWCWosJ60vuYtafyCgFioxtcAXNR8Hx0-646_6MHZ8aZsOr3KoTf5XicT9Hskhhu9TBvdkJpzyUaBby8COd2toQy6D8VC15kIaV0041JKLokiI_Xgrderyfa1I-HnM-Fv6OBe22Rv8iijKdFTgnqboN4mON3G3k_8CfdGlUM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2366636080</pqid></control><display><type>article</type><title>Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s disease</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><source>Cochrane Library</source><creator>Orgeta, Vasiliki ; McDonald, Kathryn R ; Poliakoff, Ellen ; Hindle, John Vincent ; Clare, Linda ; Leroi, Iracema ; Orgeta, Vasiliki</creator><creatorcontrib>Orgeta, Vasiliki ; McDonald, Kathryn R ; Poliakoff, Ellen ; Hindle, John Vincent ; Clare, Linda ; Leroi, Iracema ; Orgeta, Vasiliki</creatorcontrib><description>Background
Approximately 60% to 80% of people with Parkinson's disease (PD) experience cognitive impairment that impacts on their quality of life. Cognitive decline is a core feature of the disease and can often present before the onset of motor symptoms. Cognitive training may be a useful non‐pharmacological intervention that could help to maintain or improve cognition and quality of life for people with PD dementia (PDD) or PD‐related mild cognitive impairment (PD‐MCI).
Objectives
To determine whether cognitive training (targeting single or multiple domains) improves cognition in people with PDD and PD‐MCI or other clearly defined forms of cognitive impairment in people with PD.
Search methods
We searched the Cochrane Dementia and Cognitive Improvement Group Trials Register (8 August 2019), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and PsycINFO. We searched reference lists and trial registers, searched relevant reviews in the area and conference proceedings. We also contacted experts for clarifications on data and ongoing trials.
Selection criteria
We included randomised controlled trials where the participants had PDD or PD‐MCI, and where the intervention was intended to train general or specific areas of cognitive function, targeting either a single domain or multiple domains of cognition, and was compared to a control condition. Multicomponent interventions that also included motor or other elements were considered eligible.
Data collection and analysis
Two review authors independently screened titles, s, and full‐text articles for inclusion in the review. Two review authors also independently undertook extraction of data and assessment of methodological quality. We used GRADE methods to assess the overall quality of the evidence.
Main results
Seven studies with a total of 225 participants met the inclusion criteria for this review. All seven studies compared the effects of a cognitive training intervention to a control intervention at the end of treatment periods lasting four to eight weeks. Six studies included people with PD living in the community. These six studies recruited people with single‐domain (executive) or multiple‐domain mild cognitive impairment in PD. Four of these studies identified participants with MCI using established diagnostic criteria, and two included both people with PD‐MCI and people with PD who were not cognitively impaired. One study recruited people with a diagnosis of PD dementia who were living in long‐term care settings. The cognitive training intervention in three studies targeted a single cognitive domain, whilst in four studies multiple domains of cognitive function were targeted. The comparison groups either received no intervention or took part in recreational activities (sports, music, arts), speech or language exercises, computerised motor therapy, or motor rehabilitation combined with recreational activity.
We found no clear evidence that cognitive training improved global cognition. Although cognitive training was associated with higher scores on global cognition at the end of treatment, the result was imprecise and not statistically significant (6 trials, 178 participants, standardised mean difference (SMD) 0.28, 95% confidence interval (CI) −0.03 to 0.59; low‐certainty evidence). There was no evidence of a difference at the end of treatment between cognitive training and control interventions on executive function (5 trials, 112 participants; SMD 0.10, 95% CI −0.28 to 0.48; low‐certainty evidence) or visual processing (3 trials, 64 participants; SMD 0.30, 95% CI −0.21 to 0.81; low‐certainty evidence). The evidence favoured the cognitive training group on attention (5 trials, 160 participants; SMD 0.36, 95% CI 0.03 to 0.68; low‐certainty evidence) and verbal memory (5 trials, 160 participants; SMD 0.37, 95% CI 0.04 to 0.69; low‐certainty evidence), but these effects were less certain in sensitivity analyses that excluded a study in which only a minority of the sample were cognitively impaired. There was no evidence of differences between treatment and control groups in activities of daily living (3 trials, 67 participants; SMD 0.03, 95% CI −0.47 to 0.53; low‐certainty evidence) or quality of life (5 trials, 147 participants; SMD −0.01, 95% CI −0.35 to 0.33; low‐certainty evidence). There was very little information on adverse events. We considered the certainty of the evidence for all outcomes to be low due to risk of bias in the included studies and imprecision of the results.
We identified six ongoing trials recruiting participants with PD‐MCI, but no ongoing trials of cognitive training for people with PDD.
Authors' conclusions
This review found no evidence that people with PD‐MCI or PDD who receive cognitive training for four to eight weeks experience any important cognitive improvements at the end of training. However, this conclusion was based on a small number of studies with few participants, limitations of study design and execution, and imprecise results. There is a need for more robust, adequately powered studies of cognitive training before conclusions can be drawn about the effectiveness of cognitive training for people with PDD and PD‐MCI. Studies should use formal criteria to diagnose cognitive impairments, and there is a particular need for more studies testing the efficacy of cognitive training in people with PDD.</description><identifier>ISSN: 1469-493X</identifier><identifier>EISSN: 1465-1858</identifier><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD011961.pub2</identifier><identifier>PMID: 32101639</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; Akinetic‐rigid syndrome ; Cognitive Dysfunction ; Cognitive Dysfunction - rehabilitation ; Cognitive Dysfunction - therapy ; Cognitive enhancement ; Dementia ; Dementia & cognition ; Dementia - rehabilitation ; Dementia - therapy ; Humans ; Improving cognition ; Medicine General & Introductory Medical Sciences ; Mental health ; Movement disorders ; Neurology ; Parkinson Disease ; Parkinson Disease - psychology ; Parkinson's disease ; Quality of Life ; Randomized Controlled Trials as Topic ; Task Performance and Analysis</subject><ispartof>Cochrane database of systematic reviews, 2020-02, Vol.2020 (2), p.CD011961</ispartof><rights>Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32101639$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Orgeta, Vasiliki</creatorcontrib><creatorcontrib>McDonald, Kathryn R</creatorcontrib><creatorcontrib>Poliakoff, Ellen</creatorcontrib><creatorcontrib>Hindle, John Vincent</creatorcontrib><creatorcontrib>Clare, Linda</creatorcontrib><creatorcontrib>Leroi, Iracema</creatorcontrib><creatorcontrib>Orgeta, Vasiliki</creatorcontrib><title>Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s disease</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Background
Approximately 60% to 80% of people with Parkinson's disease (PD) experience cognitive impairment that impacts on their quality of life. Cognitive decline is a core feature of the disease and can often present before the onset of motor symptoms. Cognitive training may be a useful non‐pharmacological intervention that could help to maintain or improve cognition and quality of life for people with PD dementia (PDD) or PD‐related mild cognitive impairment (PD‐MCI).
Objectives
To determine whether cognitive training (targeting single or multiple domains) improves cognition in people with PDD and PD‐MCI or other clearly defined forms of cognitive impairment in people with PD.
Search methods
We searched the Cochrane Dementia and Cognitive Improvement Group Trials Register (8 August 2019), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and PsycINFO. We searched reference lists and trial registers, searched relevant reviews in the area and conference proceedings. We also contacted experts for clarifications on data and ongoing trials.
Selection criteria
We included randomised controlled trials where the participants had PDD or PD‐MCI, and where the intervention was intended to train general or specific areas of cognitive function, targeting either a single domain or multiple domains of cognition, and was compared to a control condition. Multicomponent interventions that also included motor or other elements were considered eligible.
Data collection and analysis
Two review authors independently screened titles, s, and full‐text articles for inclusion in the review. Two review authors also independently undertook extraction of data and assessment of methodological quality. We used GRADE methods to assess the overall quality of the evidence.
Main results
Seven studies with a total of 225 participants met the inclusion criteria for this review. All seven studies compared the effects of a cognitive training intervention to a control intervention at the end of treatment periods lasting four to eight weeks. Six studies included people with PD living in the community. These six studies recruited people with single‐domain (executive) or multiple‐domain mild cognitive impairment in PD. Four of these studies identified participants with MCI using established diagnostic criteria, and two included both people with PD‐MCI and people with PD who were not cognitively impaired. One study recruited people with a diagnosis of PD dementia who were living in long‐term care settings. The cognitive training intervention in three studies targeted a single cognitive domain, whilst in four studies multiple domains of cognitive function were targeted. The comparison groups either received no intervention or took part in recreational activities (sports, music, arts), speech or language exercises, computerised motor therapy, or motor rehabilitation combined with recreational activity.
We found no clear evidence that cognitive training improved global cognition. Although cognitive training was associated with higher scores on global cognition at the end of treatment, the result was imprecise and not statistically significant (6 trials, 178 participants, standardised mean difference (SMD) 0.28, 95% confidence interval (CI) −0.03 to 0.59; low‐certainty evidence). There was no evidence of a difference at the end of treatment between cognitive training and control interventions on executive function (5 trials, 112 participants; SMD 0.10, 95% CI −0.28 to 0.48; low‐certainty evidence) or visual processing (3 trials, 64 participants; SMD 0.30, 95% CI −0.21 to 0.81; low‐certainty evidence). The evidence favoured the cognitive training group on attention (5 trials, 160 participants; SMD 0.36, 95% CI 0.03 to 0.68; low‐certainty evidence) and verbal memory (5 trials, 160 participants; SMD 0.37, 95% CI 0.04 to 0.69; low‐certainty evidence), but these effects were less certain in sensitivity analyses that excluded a study in which only a minority of the sample were cognitively impaired. There was no evidence of differences between treatment and control groups in activities of daily living (3 trials, 67 participants; SMD 0.03, 95% CI −0.47 to 0.53; low‐certainty evidence) or quality of life (5 trials, 147 participants; SMD −0.01, 95% CI −0.35 to 0.33; low‐certainty evidence). There was very little information on adverse events. We considered the certainty of the evidence for all outcomes to be low due to risk of bias in the included studies and imprecision of the results.
We identified six ongoing trials recruiting participants with PD‐MCI, but no ongoing trials of cognitive training for people with PDD.
Authors' conclusions
This review found no evidence that people with PD‐MCI or PDD who receive cognitive training for four to eight weeks experience any important cognitive improvements at the end of training. However, this conclusion was based on a small number of studies with few participants, limitations of study design and execution, and imprecise results. There is a need for more robust, adequately powered studies of cognitive training before conclusions can be drawn about the effectiveness of cognitive training for people with PDD and PD‐MCI. Studies should use formal criteria to diagnose cognitive impairments, and there is a particular need for more studies testing the efficacy of cognitive training in people with PDD.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Akinetic‐rigid syndrome</subject><subject>Cognitive Dysfunction</subject><subject>Cognitive Dysfunction - rehabilitation</subject><subject>Cognitive Dysfunction - therapy</subject><subject>Cognitive enhancement</subject><subject>Dementia</subject><subject>Dementia & cognition</subject><subject>Dementia - rehabilitation</subject><subject>Dementia - therapy</subject><subject>Humans</subject><subject>Improving cognition</subject><subject>Medicine General & Introductory Medical Sciences</subject><subject>Mental health</subject><subject>Movement disorders</subject><subject>Neurology</subject><subject>Parkinson Disease</subject><subject>Parkinson Disease - psychology</subject><subject>Parkinson's disease</subject><subject>Quality of Life</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Task Performance and Analysis</subject><issn>1469-493X</issn><issn>1465-1858</issn><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>RWY</sourceid><sourceid>EIF</sourceid><recordid>eNpVUctOHDEQtKKgQEh-AfmYy2z8GHs8F6RkCQ8JCQ4g5WZ57fbiMGMv9uxG3PgNfi9fwkxgEZy6W1Vd1epC6ICSGSWEfae1FFQJNZsfEUpbSWer9YJ9QHsTUE3Ix_99W9Ut_72LPpfyhxAuW9Z8QrucUUIlb_eQm6dlDEPYAB6yCTHEJQ5xgLyBOIQUC_YpYwf9NBpsosN96By2r2uhX5mQJ3xcxJcm34ZYUvz38FiwCwVMgS9ox5uuwNeXuo-uj39dzU-r84uTs_mP82rFhGCVtIIr61XLmHKCUkqUbxZOOmkteADTWCWosJ60vuYtafyCgFioxtcAXNR8Hx0-646_6MHZ8aZsOr3KoTf5XicT9Hskhhu9TBvdkJpzyUaBby8COd2toQy6D8VC15kIaV0041JKLokiI_Xgrderyfa1I-HnM-Fv6OBe22Rv8iijKdFTgnqboN4mON3G3k_8CfdGlUM</recordid><startdate>20200226</startdate><enddate>20200226</enddate><creator>Orgeta, Vasiliki</creator><creator>McDonald, Kathryn R</creator><creator>Poliakoff, Ellen</creator><creator>Hindle, John Vincent</creator><creator>Clare, Linda</creator><creator>Leroi, Iracema</creator><creator>Orgeta, Vasiliki</creator><general>John Wiley & Sons, Ltd</general><scope>7PX</scope><scope>RWY</scope><scope>ZYTZH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200226</creationdate><title>Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s disease</title><author>Orgeta, Vasiliki ; McDonald, Kathryn R ; Poliakoff, Ellen ; Hindle, John Vincent ; Clare, Linda ; Leroi, Iracema ; Orgeta, Vasiliki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p2552-6c538cf89228d511108f7bd6d6ccefeea7c8515cf09f43907fb0e5b87f4ee3543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Akinetic‐rigid syndrome</topic><topic>Cognitive Dysfunction</topic><topic>Cognitive Dysfunction - rehabilitation</topic><topic>Cognitive Dysfunction - therapy</topic><topic>Cognitive enhancement</topic><topic>Dementia</topic><topic>Dementia & cognition</topic><topic>Dementia - rehabilitation</topic><topic>Dementia - therapy</topic><topic>Humans</topic><topic>Improving cognition</topic><topic>Medicine General & Introductory Medical Sciences</topic><topic>Mental health</topic><topic>Movement disorders</topic><topic>Neurology</topic><topic>Parkinson Disease</topic><topic>Parkinson Disease - psychology</topic><topic>Parkinson's disease</topic><topic>Quality of Life</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Task Performance and Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Orgeta, Vasiliki</creatorcontrib><creatorcontrib>McDonald, Kathryn R</creatorcontrib><creatorcontrib>Poliakoff, Ellen</creatorcontrib><creatorcontrib>Hindle, John Vincent</creatorcontrib><creatorcontrib>Clare, Linda</creatorcontrib><creatorcontrib>Leroi, Iracema</creatorcontrib><creatorcontrib>Orgeta, Vasiliki</creatorcontrib><collection>Wiley-Blackwell Cochrane Library</collection><collection>Cochrane Library</collection><collection>Cochrane Library (Open Aceess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Orgeta, Vasiliki</au><au>McDonald, Kathryn R</au><au>Poliakoff, Ellen</au><au>Hindle, John Vincent</au><au>Clare, Linda</au><au>Leroi, Iracema</au><au>Orgeta, Vasiliki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s disease</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2020-02-26</date><risdate>2020</risdate><volume>2020</volume><issue>2</issue><spage>CD011961</spage><pages>CD011961-</pages><issn>1469-493X</issn><eissn>1465-1858</eissn><eissn>1469-493X</eissn><abstract>Background
Approximately 60% to 80% of people with Parkinson's disease (PD) experience cognitive impairment that impacts on their quality of life. Cognitive decline is a core feature of the disease and can often present before the onset of motor symptoms. Cognitive training may be a useful non‐pharmacological intervention that could help to maintain or improve cognition and quality of life for people with PD dementia (PDD) or PD‐related mild cognitive impairment (PD‐MCI).
Objectives
To determine whether cognitive training (targeting single or multiple domains) improves cognition in people with PDD and PD‐MCI or other clearly defined forms of cognitive impairment in people with PD.
Search methods
We searched the Cochrane Dementia and Cognitive Improvement Group Trials Register (8 August 2019), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and PsycINFO. We searched reference lists and trial registers, searched relevant reviews in the area and conference proceedings. We also contacted experts for clarifications on data and ongoing trials.
Selection criteria
We included randomised controlled trials where the participants had PDD or PD‐MCI, and where the intervention was intended to train general or specific areas of cognitive function, targeting either a single domain or multiple domains of cognition, and was compared to a control condition. Multicomponent interventions that also included motor or other elements were considered eligible.
Data collection and analysis
Two review authors independently screened titles, s, and full‐text articles for inclusion in the review. Two review authors also independently undertook extraction of data and assessment of methodological quality. We used GRADE methods to assess the overall quality of the evidence.
Main results
Seven studies with a total of 225 participants met the inclusion criteria for this review. All seven studies compared the effects of a cognitive training intervention to a control intervention at the end of treatment periods lasting four to eight weeks. Six studies included people with PD living in the community. These six studies recruited people with single‐domain (executive) or multiple‐domain mild cognitive impairment in PD. Four of these studies identified participants with MCI using established diagnostic criteria, and two included both people with PD‐MCI and people with PD who were not cognitively impaired. One study recruited people with a diagnosis of PD dementia who were living in long‐term care settings. The cognitive training intervention in three studies targeted a single cognitive domain, whilst in four studies multiple domains of cognitive function were targeted. The comparison groups either received no intervention or took part in recreational activities (sports, music, arts), speech or language exercises, computerised motor therapy, or motor rehabilitation combined with recreational activity.
We found no clear evidence that cognitive training improved global cognition. Although cognitive training was associated with higher scores on global cognition at the end of treatment, the result was imprecise and not statistically significant (6 trials, 178 participants, standardised mean difference (SMD) 0.28, 95% confidence interval (CI) −0.03 to 0.59; low‐certainty evidence). There was no evidence of a difference at the end of treatment between cognitive training and control interventions on executive function (5 trials, 112 participants; SMD 0.10, 95% CI −0.28 to 0.48; low‐certainty evidence) or visual processing (3 trials, 64 participants; SMD 0.30, 95% CI −0.21 to 0.81; low‐certainty evidence). The evidence favoured the cognitive training group on attention (5 trials, 160 participants; SMD 0.36, 95% CI 0.03 to 0.68; low‐certainty evidence) and verbal memory (5 trials, 160 participants; SMD 0.37, 95% CI 0.04 to 0.69; low‐certainty evidence), but these effects were less certain in sensitivity analyses that excluded a study in which only a minority of the sample were cognitively impaired. There was no evidence of differences between treatment and control groups in activities of daily living (3 trials, 67 participants; SMD 0.03, 95% CI −0.47 to 0.53; low‐certainty evidence) or quality of life (5 trials, 147 participants; SMD −0.01, 95% CI −0.35 to 0.33; low‐certainty evidence). There was very little information on adverse events. We considered the certainty of the evidence for all outcomes to be low due to risk of bias in the included studies and imprecision of the results.
We identified six ongoing trials recruiting participants with PD‐MCI, but no ongoing trials of cognitive training for people with PDD.
Authors' conclusions
This review found no evidence that people with PD‐MCI or PDD who receive cognitive training for four to eight weeks experience any important cognitive improvements at the end of training. However, this conclusion was based on a small number of studies with few participants, limitations of study design and execution, and imprecise results. There is a need for more robust, adequately powered studies of cognitive training before conclusions can be drawn about the effectiveness of cognitive training for people with PDD and PD‐MCI. Studies should use formal criteria to diagnose cognitive impairments, and there is a particular need for more studies testing the efficacy of cognitive training in people with PDD.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>32101639</pmid><doi>10.1002/14651858.CD011961.pub2</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1469-493X |
| ispartof | Cochrane database of systematic reviews, 2020-02, Vol.2020 (2), p.CD011961 |
| issn | 1469-493X 1465-1858 1469-493X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7043362 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Cochrane Library |
| subjects | Activities of Daily Living Aged Aged, 80 and over Akinetic‐rigid syndrome Cognitive Dysfunction Cognitive Dysfunction - rehabilitation Cognitive Dysfunction - therapy Cognitive enhancement Dementia Dementia & cognition Dementia - rehabilitation Dementia - therapy Humans Improving cognition Medicine General & Introductory Medical Sciences Mental health Movement disorders Neurology Parkinson Disease Parkinson Disease - psychology Parkinson's disease Quality of Life Randomized Controlled Trials as Topic Task Performance and Analysis |
| title | Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T10%3A08%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cognitive%20training%20interventions%20for%20dementia%20and%20mild%20cognitive%20impairment%20in%20Parkinson%E2%80%99s%20disease&rft.jtitle=Cochrane%20database%20of%20systematic%20reviews&rft.au=Orgeta,%20Vasiliki&rft.date=2020-02-26&rft.volume=2020&rft.issue=2&rft.spage=CD011961&rft.pages=CD011961-&rft.issn=1469-493X&rft.eissn=1465-1858&rft_id=info:doi/10.1002/14651858.CD011961.pub2&rft_dat=%3Cproquest_pubme%3E2366636080%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2366636080&rft_id=info:pmid/32101639&rfr_iscdi=true |