Impact of cognitive intervention on cognitive symptoms and quality of life in idiopathic Parkinson’s disease: a randomized and controlled study

Abstract

ABSTRACT. Pharmacological treatments for mild cognitive impairment (MCI), are lacking, and alternative approaches have been implemented, including cognitive training (CT). Objective: To determine the impact of CT on cognitive and quality of life measures in patients with Parkinson’s disease (PD) who were seen a hospital neurorehabilitation program. Methods: Thirty-nine individuals with MCI-PD, according to the Movement Disorder Society, were randomly distributed into two groups: experimental and control group, matched for demographic and clinical characteristics. Both groups were assessed for cognition and quality of life at the beginning of the study and at the end of the intervention protocol. The following instruments were used to assess cognition and quality of life: Addenbrooke’s Cognitive Examination III, Digit Span, Trail Making Test (TMT, A and B) and Parkinson disease quality of life questionnaire. The experimental group (EG) engaged in CT, whereas the control group (CG) underwent activities of the general rehabilitation program. Results: No baseline evaluation differences were found. Intergroup analysis showed differences in measures, such as total score (1.977, p=0.0480) and visuospatial domain (-2.636, p=0.0084) of the ACE-III, with the EG performing better, in addition to better performance in TMT-B mistakes (-1.928, p=0.0439). Intragroup analysis revealed that the EG showed significant improvement in almost all the cognitive variables, well as in self-reported quality of life (total score and mobility, activities of daily living, body discomfort dimensions). Conclusions: Engagement in cognitive activities was associated with better cognitive abilities in PD-MCI. Future studies should consider the long-term effect of this type of intervention and impact on functional activities.

Orofacial myofunctional assessment and quality of life of individuals with Parkinson's disease

“…33,35 Considering that the PD patient may show impairment in several vital aspects such as feeding, communication, and locomotion, understanding their perception of QoL is essential to improve the daily living activities. 5,7,8,19 It was observed that as PD progresses and its symptoms become more evident, the scores of the PDQ-39 also increase and QoL tends to get worse. Interestingly, differences in the scores of mobility and activities of daily living domains are the aspects that impact the individuals QoL the most, probably due to the disease progress and its most evident symptoms: bradykinesia, rigidity, postural instability, and resting tremor.…”

“…The validated version of the Parkinson's Disease Questionnaire (PDQ-39) 8 was applied to PG with the aim of assessing their overall quality of life; it comprises 39 questions that measure eight health domains in PD: functional mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort. The score for each question ranges from zero (0) to four ( 4).…”

“…Participants with natural teeth or removable dentures that remained stable during mastication were assessed using a scale in which 1 indicated no mastication and 10 indicated bilateral and alternating mastication. When the denture was displaced during mastication, the score values ranged from one (1) to eight (8). The presence of other behavior and signs were also analyzed using a scale in which 1 indicated the presence and 2 the absence of each sign.…”

“…When these symptoms appear, approximately 70% of the dopaminergic neurons have already degenerated. 8 These changes may extend throughout the musculoskeletal and stomatognathic systems, including the neck and face, and affect mandibular movement and masticatory, phonatory, and swallowing functions. 4 Speech can become compromised due to hypokinetic dysarthria, which occurs in about 90% of patients and may also have swallowing alterations in all phases of PD.…”

“…Changes in the phono‐articulatory system may include rigidity, bradykinesia, and resting tremors. When these symptoms appear, approximately 70% of the dopaminergic neurons have already degenerated 8 . These changes may extend throughout the musculoskeletal and stomatognathic systems, including the neck and face, and affect mandibular movement and masticatory, phonatory, and swallowing functions 4 .…”