Development and efficacy of a compensatory skill building program: Parkinson’s disease cognitive rehabilitation for executive functioning (PD-CoRE)

Development and efficacy of a compensatory skill building program: Parkinson’s disease cognitive rehabilitation for executive functioning (PD-CoRE)

Hannah L. Combs, Ph.D.1, Stella H. Kim, Psy.D.2, & Michele K. York, Ph.D., ABPP-CN*1, 3

ABSTRACT

Objective: Cognitive dysfunction is a major clinical feature of PD that contributes to disability, caregiver strain, and diminished quality of life over the disease course. Cognitive rehabilitation has mounting evidence as an intervention relevant for improving quality of life for people living with PD. The Parkinson’s Disease Cognitive Rehabilitation of Executive functioning (PD-CoRE) program is a new cognitive rehabilitation program designed to teach compensatory skills that address daily struggles secondary to executive dysfunction and to break the cycle of cognitive impairment, depression, apathy, poor self-efficacy, reduced quality of life, and increased caregiver burden. The aim of the current study was to evaluate the efficacy of the PD-CoRE program in improving executive functions of individuals with PD and mild cognitive impairment.
Methods: Standardized neuropsychological tests and ecologically valid outcome measures were administered to assess executive functions in addition to mood, apathy, self-efficacy, life satisfaction, quality of life, and caregiver burden. A series of Wilcoxon signed-rank tests were performed.
Results: Results revealed initial improvements in immediate attentional capacity and long-term improvements in inhibition, delayed verbal recall, and verbal memory discrimination. 50% of participants reported subjective improvement in their ability to engage in daily activities, and 50% reported increased self-efficacy. Results from informants revealed that 40% of spouses perceived improvements in the participant’s self-regulatory abilities, and 60% reported observing improvements in the participants’ ability to manage activities of daily living.
Conclusion: Findings from the present study provide support for the feasibility and, if cross-validated, the efficacy of the PD-CoRE program in PD patients with executive dysfunction.

1 Baylor College of Medicine, Department of Neurology, Houston, TX
2 The University of Texas Health Science Center at Houston, Department of Neurology, Houston, TX
3 Michael E. DeBakey Veterans Affairs Medical Center, Parkinson’s disease Research, Education, and Clinical Center (PADRECC), Houston, TX

*Corresponding Author:
Michele K. York, Ph.D., ABPP-CN 7200 Cambridge St. 9th Floor, Houston, TX 77030
Ph.: 713-798-8673,
fax: 713-798-8573
Email: myork@bcm.edu

Keywords:

Parkinson’s disease, executive functions, cognitive rehabilitation, mild cognitive impairment, compensatory strategies, quality of life

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