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      Feasibility and Acceptability of Computerised Cognitive Training of Everyday Cognition in Parkinson's Disease

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          Abstract

          Objectives

          We piloted a computerised cognitive training battery in a group of participants with Parkinson's disease without dementia to investigate the relevance of the training to daily life and the feasibility and the acceptability of the tasks. Previous studies of CT have had limited success in the benefits of training, extending to improvements in everyday function. By taking a pragmatic approach and targeting training to the cognitive skills affected by Parkinson's disease (planning, attention, and recollection), whilst using tasks that emulated real-life scenarios, we sought to understand whether participants perceived the training to be effective and to identify the elements of the training that elicited beneficial effects.

          Methods

          Four participants completed a cognitive training session comprising three distinct tasks 5 days a week over two weeks. Participants completed baseline questionnaires examining health-related quality of life, everyday cognition, and apathy before the training period, after the last session, and two weeks after the last session. An interview was held after participants had completed the training.

          Results

          The findings indicated that participants felt the training was acceptable, enhanced their awareness, and encouraged them to monitor their thinking abilities. The group interview indicated that the training was feasible; participants felt the tasks had potential to improve everyday performance, but more supporting information should be provided to facilitate this transfer. Responses to the questionnaires reflected these findings, indicating improvement for some participants' cognition and quality of life. Objective measures supported the subjective reports; there were improvements in some but not all domains. Performance on the planning and recollection tasks improved over the training period, and the evidence for improvement on the attention task was mixed.

          Conclusion

          This study has found that pragmatic computer-based training with real-life outcomes is both feasible and acceptable and should be evaluated more extensively using controlled methods.

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          Most cited references30

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          PEST: Efficient Estimates on Probability Functions

          M Taylor (1967)
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            Social isolation, cognitive reserve, and cognition in healthy older people

            There is evidence to suggest that social isolation is associated with poor cognitive health, although findings are contradictory. One reason for inconsistency in reported findings may be a lack of consideration of underlying mechanisms that could influence this relationship. Cognitive reserve is a theoretical concept that may account for the role of social isolation and its association with cognitive outcomes in later life. Therefore, we aimed to examine the relationship between social isolation and cognition in later life, and to consider the role of cognitive reserve in this relationship. Baseline and two year follow-up data from the Cognitive Function and Ageing Study–Wales (CFAS-Wales) were analysed. Social isolation was assessed using the Lubben Social Network Scale-6 (LSNS-6), cognitive function was assessed using the Cambridge Cognitive Examination (CAMCOG), and cognitive reserve was assessed using a proxy measure of education, occupational complexity, and cognitive activity. Linear regression modelling was used to assess the relationship between social isolation and cognition. To assess the role of cognitive reserve in this relationship, moderation analysis was used to test for interaction effects. After controlling for age, gender, education, and physically limiting health conditions, social isolation was associated with cognitive function at baseline and two year follow-up. Cognitive reserve moderated this association longitudinally. Findings suggest that maintaining a socially active lifestyle in later life may enhance cognitive reserve and benefit cognitive function. This has important implications for interventions that may target social isolation to improve cognitive function.
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              Blind randomized controlled study of the efficacy of cognitive training in Parkinson's disease.

              The aim of this study was to analyze the efficacy of a cognitive training program on cognitive performance and quality of life in nondemented Parkinson's disease patients. Participants who met UK Brain Bank diagnosis criteria for Parkinson's disease, with I-III Hoehn & Yahr, aged 50-80, and nondemented (Mini-Mental State Examination ≥ 23) were recruited. Patient's cognitive performance and functional and quality-of-life measures were assessed with standardized neuropsychological tests and scales at baseline and after 4 weeks. Subjects were randomly and blindly allocated by age and premorbid intelligence (Vocabulary, Wechsler Adult Intelligence Scale-III) into 2 groups: an experimental group and a control group. The experimental group received 4 weeks of 3 weekly 45-minute sessions using multimedia software and paper-and-pencil cognitive exercises, and the control group received speech therapy. A total of 28 patients were analyzed. Compared with the control group participants (n = 12), the experimental group participants (n = 16) demonstrated improved performance in tests of attention, information processing speed, memory, visuospatial and visuoconstructive abilities, semantic verbal fluency, and executive functions. There were no observable benefits in self-reported quality of life or cognitive difficulties in activities of daily living. We concluded that intensive cognitive training may be a useful tool in the management of cognitive functions in Parkinson's disease. © 2011 Movement Disorder Society. Copyright © 2011 Movement Disorder Society.
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                Author and article information

                Contributors
                Journal
                Parkinsons Dis
                Parkinsons Dis
                PD
                Parkinson's Disease
                Hindawi
                2090-8083
                2042-0080
                2019
                22 July 2019
                : 2019
                : 5258493
                Affiliations
                1Centre for Dementia Research, Leeds Beckett University, Leeds, UK
                2Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, UK
                3Greater Manchester Mental Health Foundation Trust, Prestwich, UK
                4Global Brain Health Institute, Trinity College Dublin, Dublin 2, Ireland
                5Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, UK
                Author notes

                Academic Editor: Hélio Teive

                Author information
                https://orcid.org/0000-0002-1561-9485
                https://orcid.org/0000-0003-1822-3643
                https://orcid.org/0000-0002-7691-6184
                https://orcid.org/0000-0002-3471-1527
                https://orcid.org/0000-0003-4975-7787
                Article
                10.1155/2019/5258493
                6679888
                1bb9cdca-2f64-4549-b747-d646d543e564
                Copyright © 2019 S. J. Smith et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 December 2018
                : 26 March 2019
                : 30 May 2019
                Funding
                Funded by: Wellcome Trust
                Categories
                Research Article

                Neurology
                Neurology

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