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.

Purpose This study aimed to determine predictors of health-related quality of life (HRQoL) in Parkinson's disease (PD) and to explore their predictive value before and after controlling overlapping items between HRQoL and clinical variables. Methods One hundred and eight PD patients underwent motor, anxiety, depression, apathy, fatigue, and neurocognition assessment. HRQoL was assessed by the Parkinson’s Disease Questionnaire-39 (PDQ-39). In order to determine predictors of HRQoL in PD, stepwise multiple regression analyses were performed in two ways: before and after removing the emotional well-being dimension from PDQ-39 to control the overlap between depression and anxiety, and HRQoL. Results HRQoL total index was predicted by anxiety, fatigue, motor symptoms, and depression, explaining 26.9%, 7.2%, 2.8%, and 1.9% of the variance. However, after removing overlapping items, HRQoL total index was predicted by fatigue (16.5%), anxiety (6.1%), motor symptoms (3.9%), and neurocognition (2.5%), but not depression. Regarding HRQoL dimensions, mobility and activities of daily living were predicted by fatigue (19.7% and 5%) and UPDRS-III (4% and 10.2%); emotional well-being by fatigue (7.9%); social support by anxiety (12.2%) and UPDRS-III (8.6%); communication by neurocognition (5.3%) and UPDRS-III (3.4%); cognition by anxiety (10.6%) and bodily discomfort by anxiety (23%) and fatigue (4.1%). Conclusion These findings showed the importance of identifying and controlling overlapping items of HRQoL and clinical measures to perform an accurate interpretation. HRQoL dimensions showed different predictors before and after controlling the overlap. Based on these results fatigue, anxiety, motor symptoms, and neurocognition, but not depression are the main predictors of HRQoL in PD patients.

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La enfermedad de Parkinson (EP) es una enfermedad principalmente conocida por sus síntomas motores. Sin embargo, esta enfermedad puede cursar con el deterioro de ciertas funciones cognitivas (memoria, atención, habilidades visuoespaciales…), asociándose a una reducción de la calidad de vida de las personas con EP y de su entorno más cercano. A medida que la enfermedad avanza, incrementa la necesidad de cuidado, que suele estar proporcionado por cuidadores informales. El presente briefing está destinado a entidades o profesionales que tengan interés en aplicar en sus centros una intervención combinada de rehabilitación cognitiva en personas con EP y psicoeducación en sus familiares cuidadores. El objetivo es mejorar las funciones cognitivas y la calidad de vida de las personas con EP y sus familiares. La implicación de los familiares puede proporcionar un enfoque integral en el proceso rehabilitador y potenciar los beneficios en las personas con EP, así como ofrecer estrategias para fomentar una mejor calidad de vida en los propios cuidadores.

Parkinson’s Disease (PD) is mainly known for its motor symptoms. However, it can also involve the impairment of certain cognitive functions (memory, attention, visuospatial skills, etc.), and is associated with a lower quality of life among people with PD and those closest to them. As the disease progresses, there is a greater need for care, which is generally provided by informal caregivers. This briefing is aimed at organisations and specialists interested in applying a combined intervention of cognitive rehabilitation for people with PD and psychoeducation for their family caregivers at their centres. The goal is to improve the cognitive functions and quality of life of people with PD and their families. Involving families can provide an integrated approach to the rehabilitation process and strengthen the benefits for people with PD, while at the same time offering strategies for fostering better quality of life among caregivers.