Our Parkinson's Place: Goal-Oriented Cognitive Rehabilitation vs As-Usual Care Outcomes in Parkinson Disease

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Monday, January 29, 2018

Goal-Oriented Cognitive Rehabilitation vs As-Usual Care Outcomes in Parkinson Disease

Jessica Martin

January 29, 2018

Study results provide evidence of the efficacy of goal-oriented cognitive rehabilitation for patients with Parkinson disease-associated dementias.

Among patients with Parkinson disease-associated dementias, goal-oriented cognitive rehabilitation improved goal attainment and related satisfaction and may be an effective nonpharmacologic therapy in this patient population, according to research published in the International Journal of Geriatric Psychiatry.

In this pilot randomized controlled trial (Cognitive Rehabilitation for Parkinson's Disease Dementia; CORD PD), participants with dementias associated with Parkinson disease were randomly assigned to receive goal-oriented cognitive rehabilitation (n=10), relaxation therapy (n=10), or treatment as usual (n=9). At baseline, all participants set goals for themselves in an interview. The primary outcomes were self-rated goal attainment and satisfaction with goal attainment at 2 and 6 months.

Cognitive rehabilitation improved self-rated goal attainment compared with treatment as usual (P=.004) and with relaxation therapy (P =.002) at 2 months. Similarly, at 6 months, cognitive rehabilitation remained superior to both treatment as usual (P =.015) and relaxation therapy (P=.003).

Compared with treatment as usual and relaxation therapy at 2 months, cognitive rehabilitation was associated with improved mood, self-efficacy, social domain of quality of life, and caregiver-rated goal attainment. Similarly, at 6 months, delayed recall, health status, quality of life, and caregiver-rated goal attainment were improved in patients who received cognitive rehabilitation relative to the other groups.

Caregivers of patients enrolled in cognitive rehabilitation reported lower stress levels and higher overall health compared with caregivers of patients in the control groups.

The study authors concluded that the results "provide primary evidence of the potential effectiveness of goal-oriented [cognitive rehabilitation] for promoting functional independence in people with [Parkinson disease dementia] and [dementia with Lewy bodies], and improving their well-being and that of their [caregivers]."