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. 2019 Jul 4:12:1756286419852217.
doi: 10.1177/1756286419852217. eCollection 2019.

Parkinson's-adapted cognitive stimulation therapy: a pilot randomized controlled clinical trial

Iracema Leroi  1 , Sabina Vatter  2 , Lesley-Anne Carter  3 , Sarah J Smith  4 , Vasiliki Orgeta  5 , Ellen Poliakoff  2 , Monty A Silverdale  6 , Jason Raw  7 , David J Ahearn  8 , Christine Taylor  9 , Joanne Rodda  10 , Tarek Abdel-Ghany  11 , Sheree A McCormick  2
Affiliations

Parkinson's-adapted cognitive stimulation therapy: a pilot randomized controlled clinical trial

Iracema Leroi et al. Ther Adv Neurol Disord. .

Abstract

Cognitive stimulation therapy (CST) is widely used with people with dementia, but there is no evidence of its efficacy in mild cognitive impairment or dementia in Parkinson's disease (PD-MCI; PDD) or dementia with Lewy bodies (DLB). We aimed to explore the impact of 'CST-PD', which is home-based, individualized CST adapted for this population. In a single-blind, randomized controlled exploratory pilot trial (RCT), we randomized 76 participant-dyads [PD-MCI (n = 15), PDD (n = 40), DLB (n = 21) and their care partners] to CST-PD or treatment as usual (TAU). CST-PD involves home-based cognitively stimulating and engaging activities delivered by a trained care partner. Exploratory outcomes at 12 weeks included cognition (Addenbrooke's Cognitive Evaluation; ACE-III), neuropsychiatric symptoms and function. In care partners, we assessed burden, stress and general health status. Relationship quality and quality of life were assessed in both dyad members. At 12 weeks, the ACE-III showed a nonstatistically significant improvement in the CST-PD group compared with the TAU group, although neuropsychiatric symptoms increased significantly in the former. In contrast, care partners' quality of life (d = 0.16) and relationship quality ('satisfaction', d = 0.01; 'positive interaction', d = 0.55) improved significantly in the CST-PD group, and care burden (d = 0.16) and stress (d = 0.05) were significantly lower. Qualitative findings in the CST-PD recipients revealed positive 'in the moment' responses to the intervention, supporting the quantitative results. In conclusion, care-partner-delivered CST-PD may improve a range of care-partner outcomes that are important in supporting home-based care. A full-scale follow-up RCT to evaluate clinical and cost effectiveness is warranted.

Keywords: Parkinson’s disease dementia (PDD); cognitive stimulation therapy (CST); dementia with Lewy bodies (DLB); feasibility pilot trial; psychosocial therapy.

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Conflict of interest statement

Conflict of interest statement: VO has a patent: iCST Manual. No other authors have received any funding from any institution, including personal relationships, interests, grants, employment, affiliations, patents, inventions, honoraria, consultancies, royalties, stock options/ownership or expert testimony for the last 12 months. VO has a patent: iCST Manual. The other authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
CONSORT 2010 flow diagram.
See this image and copyright information in PMC

References

    1. McKeith IG, Burn D. Spectrum of Parkinson’s disease, Parkinson’s dementia, and Lewy body dementia. Neurol Clin 2000; 18: 865–883. - PubMed
    1. Aarsland D, Bronnick K, Williams-Gray C, et al. Mild cognitive impairment in Parkinson disease: a multicenter pooled analysis. Neurology 2010; 75: 1062–1069. - PMC - PubMed
    1. Hely MA, Reid WGJ, Adena MA, et al. The Sydney Multicenter Study of Parkinson’s disease: the inevitability of dementia at 20 years. Mov Disord 2008; 23: 837–844. - PubMed
    1. Leroi I, McDonald K, Pantula H, et al. Cognitive impairment in parkinson disease: impact on quality of life, disability, and caregiver burden. J Geriatr Psychiatry Neurol 2012; 25: 208–214. - PubMed
    1. Sindhi A, Leroi I. Nonpharmacological therapies for cognitive enhancement in Parkinson’s disease: applying old interventions in a new setting? Neurodegener Dis Manag 2013; 3: 1–9.

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