Initial outcomes of a combined cognitive–behavioral therapy and attention process training intervention for older adults with Parkinson’s disease.

Abstract

Parkinson's disease (PD) is a neurodegenerative disorder most notable for its motoric symptoms (e.g., bradykinesia, resting tremor, rigidity). Although cognitive deficits, anxiety, and depression are also widely reported in PD, there is limited research addressing these symptoms. Current interventions are almost exclusively targeted toward motor symptoms and are largely pharmacological in nature, despite issues with long-term efficacy and medication management. The aim of this pilot study was to describe the preliminary effects of a combined cognitive-behavioral therapy and attention training intervention in a small sample of older adults with PD, an anxiety disorder, and self-reported problems with executive functions (n ϭ 10). According to indices of reliable change on outcome measures, improvement in anxiety and depressive symptomatology as well as cognitive domains was observed. Moreover, 50% of participants were free of diagnosed anxiety disorders following treatment. Despite limitations, this study adds to the literature on nonpharmacological interventions for neuropsychiatric symptoms in PD. Clinical Impact StatementAs a result of the burgeoning elderly population, the need for research on nonmotoric symptoms and nonpharmacological interventions in Parkinson's disease is evident. Ten patients with Parkinson's disease showed improvement in anxiety, depression, and complex cognitive abilities after completing cognitive-behavioral therapy augmented with an attention enhancement program. These findings point to the potential benefit of incorporating cognitive remediation into interventions for depressed and anxious adults with Parkinson's disease.

A Conceptual View of Cognitive Intervention in Older Adults With and Without Cognitive Decline—A Systemic Review

“…Examples are the game exercises (Sweep Seeker, Bird Safari, Target Tracker, Master Gardener, and Double decision) from the ACTIVE study ( Vance et al, 2017 ), Mindfit ( Verghese et al, 2010 ), and PSSCogRehab ( Choi et al, 2018 ). Only two of the included studies followed a pre and post-test design, including cognitive-behavioral therapy and attention process training (not using computerized tasks), applied to participants with PD ( Mohlman et al, 2011 ; Mohlman et al, 2017 ).…”

Psychophysical and Computational Signatures of Visual Working Memory Deficits in Adolescents with Anxiety Disorder

“…proposed as a promising therapeutic strategy for anxiety (Iacoviello & Charney, 2015;Mohlman, 2004). The effects of cognitive training on AAD requires further verifications in future research.…”