Rehabilitation training improves subjective cognitive decline in Parkinson's disease patients: A prospective analysis

Abstract

Background: The predictive value of subjective cognitive decline in Parkinson's disease (PD-SCD) remains controversial. However, there is growing evidence that individuals with subjective cognitive decline (SCD) are associated with Alzheimer's disease pathology and are a higher risk for cognitive decline. The aim of the present study is to characterize PD-SCD and its progression, assess the effects of rehabilitation training programs on cognitive function in PD patients.Methods: Forty-two PD patients were evaluated with a neuropsychological protocol, and classified depending on the presence (PD-SCD+, n=22) or absence of SCD (PD-SCD-,n=20). After a mean follow-up of 3.0 years (2.0-4.0 years), we repeated the cognitive assessments with the same subjects. The rehabilitation training for individuals with PD for six months after the re-assessment.Results: The clinical characteristics and overall cognitive performance of the 2 groups did not differ from baseline. During the follow-up assessment, patients with PD-SCD exhibited a more significant annual decline in Chinese-Beijing version of Montreal Cognitive Assessment-Test (BJ-MoCA) and semantic fluency than patients without PD-SCD. Stepwise logistic regression analysis showed that the MMSE Scores(P=0.000), HAMD Scores (P=0.008), male (P=0.026), and the presence of SCD (P=0.022) were risk factors for language and related functions domain. There are significant improvements detected in 2 groups after rehabilitation training in terms of BJ-MoCA. Pairwise comparisons showed that language at post-intervention in the PD-SCD+ groups were significantly higher than at pre-intervention in the PD-SCD-.Conclusion: With the progression of the disease, the cognitive performance of patients with PD-SCD+ was worse than PD-SCD-. Meanwhile, the present data indicate that semantic fluency might be a key component to evaluate the cognitive subset of PD. Rehabilitation training is a viable intervention for PD that can improve several non-motor domains, produced larger improvements in cognition.