Objective/Rationale: In the twenty-first century the motor symptoms of Parkinson’s disease (PD) are typically well-managed. The neurocognitive symptoms of Parkinson’s disease often result in significant, progressive decrease in individuals’ activity levels, quality of life, and independence. Therapies targeting neurocognitive symptoms are critically needed to help individuals’ with PD live well. The goal of this study is to evaluate the practicality and effectiveness of memory and problem solving training compared to supportive therapy in individuals with PD with Mild Cognitive Impairment (MCI) and their support persons.
Project Description:
This study evaluates the benefits of memory and problem solving training compared to supportive therapy in individuals with PD with MCI and their support persons. Participants will be randomly assigned to receive memory and problem solving training or supportive therapy for two months. A six-month follow up evaluation will establish if benefits remain over time. The memory and problem solving training consists of a day calendar manual and note-taking system and problem solving techniques. The supportive therapy offers patients and support persons the opportunity to discuss and reflect upon both PD and non-PD related problems. Impact of these therapies on thinking abilities, physical health, and patient and support person ratings of thinking skills, mood and quality of life will be evaluated.
Relevance to Diagnosis/Treatment of Parkinson’s Disease:
This study will determine whether memory and problem solving therapies and supportive therapy help individuals with PD and MCI maintain or improve their thinking skills or mood over time. If positive benefit is observed, these therapies offer strategies that patients can use as their symptoms change, with minimal cost and no side effects. Therapies that help individuals maintain or improve thinking skills and mood are likely to directly impact individuals’ daily lives, including their activity levels, quality of life, and independence.
Anticipated Outcome:
Results from this study will determine whether memory and problem solving therapies and supportive therapy are easily used by and beneficial for individuals with PD and MCI. If positive benefit is observed, information from this study will be used to further optimize these therapies for larger trials designed to evaluate the value of the therapies for individuals with PD and their support persons.
Progress Report
Preliminary results from twenty-eight of the total thirty-one participants who have completed the trial to date showed that both individuals who received the memory and problem solving training or supportive therapy experienced significant improvements. Improvements were observed on tests of learning and memory and mental flexibility as well as a select basic attention task. Reductions in self-reported social phobia and stigma related to Parkinson’s disease and improvements in self-reported overall quality of life and everyday language, visuospatial, and memory skills were also observed. Participants who received the memory and problem solving training experienced significant improvements on a mental flexibility task. These results were observed even six months after the intervention, which suggests that individuals not only benefit from these therapies, but also can maintain successful use of the strategies on their own.