title: Improving functional disability and cognition in Parkinson disease: randomized controlled trial.
abstract: OBJECTIVE
  To examine the efficacy of an integrative cognitive training program (REHACOP) to improve cognition, clinical symptoms, and functional disability of patients with Parkinson disease (PD).
  
  
  METHODS
  Forty-two patients diagnosed with PD in Hoehn & Yahr stages 1 to 3 were randomly assigned to either the cognitive training group (REHACOP) or the control group (occupational activities) for 3 months (3 sessions, 60 min/wk). Primary outcomes were change on processing speed, verbal memory, visual memory, executive functioning, and theory of mind. Secondary outcomes included changes on neuropsychiatric symptoms, depression, apathy, and functional disability. The trial was registered with clinicaltrials.gov (NCT02118480).
  
  
  RESULTS
  No baseline group differences were found. Bootstrapped analysis of variance results showed significant differences in the mean change scores between the REHACOP group and control group in processing speed (0.13 [SE = 0.07] vs -0.15 [SE = 0.09], p = 0.025), visual memory (0.10 [SE = 0.10] vs -0.24 [SE = 0.09], p = 0.011), theory of mind (1.00 [SE = 0.37] vs -0.27 [SE = 0.29], p = 0.013), and functional disability (-5.15 [SE = 1.35] vs 0.53 [SE = 1.49], p = 0.012).
  
  
  CONCLUSIONS
  Patients with PD receiving cognitive training with REHACOP demonstrated statistically significant and clinically meaningful changes in processing speed, visual memory, theory of mind, and functional disability. Future studies should consider the long-term effect of this type of intervention. These findings support the integration of cognitive training into the standard of care for patients with PD.
  
  
  METHODS
  This study provides Class II evidence that for patients with PD, an integrative cognitive training program improves processing speed, visual memory, theory of mind, and functional disability.
authors.affiliation: From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Peña
authors.affiliation: From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain. naroa.ibarretxe@deusto.es.
authors.forename: Naroa
authors.initials: N
authors.lastname: Ibarretxe-Bilbao
authors.affiliation: From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: García-Gorostiaga
authors.affiliation: From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain.
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Gomez-Beldarrain
authors.affiliation: From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Díez-Cirarda
authors.affiliation: From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Ojeda
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome