title: Cognitive training in Parkinson's disease reduces cognitive decline in the long term.
abstract: OBJECTIVE
  Patients with Parkinson's disease (PD) are at high risk for cognitive dysfunction. Non-pharmacological interventions have attracted increasing interest for enhancing PD patients' cognitive functions.
  
  
  METHODS
  One-year follow-up data (T2 ) of a randomized controlled trial evaluating two 6-week cognitive trainings - a structured (NEUROvitalis, NV) and an unstructured (mentally fit, MF) program - compared with a waiting list control group (CG) in non-demented PD patients (Hoehn and Yahr I-III) are presented. Forty-seven PD patients were examined at T2 . Effects on overall cognitive functions (Mini-Mental State Examination and DemTect) were compared between all groups with repeated measurement analyses of variance. A combined score of the percentage change value from baseline (T0 ) to T2 was calculated to identify patients who retained or improved their cognitive state (responders). The risk of developing mild cognitive impairment (MCI) was analyzed.
  
  
  RESULTS
  Significant time × treatment effects on overall cognitive functions were found for both training groups, each compared separately to the CG (DemTect, P < 0.05). Nine patients (56.3%) of the NV group, seven (41.2%) of the MF group and three (21.4%) of the CG were responders. Comparing NV to CG the odds ratio was 4.7 [95% confidence interval (0.8; 33.3)], and comparing MF to CG it was 2.6 [95% confidence interval (0.4; 17.4)]. MCI risk for patients without prior MCI was 40.0% in CG, 18.2% in MF and 18.2% in NV. The odds ratio was 3 comparing NV to CG, MF to CG.
  
  
  CONCLUSIONS
  This study gives evidence that cognitive training may be effective to prevent cognitive decline and onset of MCI in PD patients.
authors.affiliation: Institute of Gerontology, Psychological Gerontology and Center for Neuropsychological Diagnostics and Intervention CeNDI, University of Vechta, Vechta, Germany; Department of Neurology, University Hospital Cologne, Cologne, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Petrelli
authors.forename: S
authors.initials: S
authors.lastname: Kaesberg
authors.forename: M T
authors.initials: MT
authors.lastname: Barbe
authors.forename: L
authors.initials: L
authors.lastname: Timmermann
authors.forename: J B
authors.initials: JB
authors.lastname: Rosen
authors.forename: G R
authors.initials: GR
authors.lastname: Fink
authors.forename: J
authors.initials: J
authors.lastname: Kessler
authors.forename: E
authors.initials: E
authors.lastname: Kalbe
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D060825:Cognitive Dysfunction / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
keywords: Parkinson's disease; cognitive training; follow-up; intervention; mild cognitive impairment