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Open Access 01-07-2019 | Care | Original Communication

Parkinson’s-adapted cognitive stimulation therapy: feasibility and acceptability in Lewy body spectrum disorders

Authors: Sheree A. McCormick, Sabina Vatter, Lesley-Anne Carter, Sarah J. Smith, Vasiliki Orgeta, Ellen Poliakoff, Monty A. Silverdale, Jason Raw, David J. Ahearn, Christine Taylor, Joanne Rodda, Tarek Abdel-Ghany, Benjamin Kwapong, Iracema Leroi

Published in: Journal of Neurology | Issue 7/2019

Abstract

Background

Drug-based therapeutic approaches for Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) are moderately effective and not always tolerated. Tailoring psychosocial approaches in PDD and DLB may offer additional support and improve outcomes. We adapted home-based, care partner-delivered Cognitive Stimulation Therapy (CST) for individuals with PDD or DLB and their care partners (CST-PD).

Objectives

To evaluate the feasibility, acceptability, and tolerability of CST-PD.

Methods

This randomised controlled trial used mixed methods, including a process evaluation. People with PDD, DLB or mild cognitive impairment in PD (PD-MCI) and their care partners were randomised to 12 weeks of treatment as usual (TAU) or CST-PD. Outcomes were feasibility of the study conduct (i.e., recruitment, retention rate) and acceptability and tolerability of the intervention. Measures included rating scales, researcher field notes, therapy diaries, and exploratory clinical and care partner efficacy measures.

Results

The recruitment target was met with 76 consenting participant-dyads. Retention in both arms was high at over 70%. More than 90% of dyads undertook discrete sessions greater than 20 min duration, but the average number of sessions completed was lower than the recommended dose. Acceptability ratings (i.e., interest, motivation and sense of achievement) of the intervention were high. Participants reported no serious adverse events related to the intervention.

Conclusions

The field of psychosocial interventions for PDD and DLB is newly emerging, and we demonstrated that this type of intervention is acceptable and well tolerated. Evaluating its clinical effectiveness in a full-scale randomized controlled clinical trial is warranted.

Trial registration number

The trial is a psychosocial intervention with an allocated ISRCTN number 11455062.

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Hobson P, Meara J (2015) Mild cognitive impairment in Parkinson’s disease and its progression onto dementia: a 16-year outcome evaluation of the Denbighshire cohort. Int J Geriatr Psychiatry 30:1048–1055. https://doi.org/10.1002/gps.4261 CrossRefPubMed

Savica R, Grossardt BR, Rocca WA, Bower JH (2018) Parkinson disease with and without Dementia: a prevalence study and future projections. Mov Disord 33:537–543. https://doi.org/10.1002/mds.27277 CrossRefPubMedPubMedCentral

Kane JPM, Surendranathan A, Bentley A et al (2018) Clinical prevalence of Lewy body dementia. Alzheimers Res Ther 10:19CrossRefPubMedPubMedCentral

Orrell M, Yates L, Leung P et al. (2017) The impact of individual cognitive stimulation therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: a randomised controlled trial. PLoS Med 14(3):e1002269. https://doi.org/10.1186/ISRCTN65945963 CrossRefPubMedPubMedCentral

Clare L, Kudlicka A, Bayer A et al (2017) Goal-oriented cognitive rehabilitation in early-stage Alzheimer’s and related dementias: results from a multi-centre, single-blind, randomised controlled trial (the Great Trial). Alzheimer’s Dement 13:P899–P900. https://doi.org/10.1016/j.jalz.2017.07.312 CrossRef

Sindhi A, Leroi I (2013) Nonpharmacological therapies for cognitive enhancement in Parkinson’s disease: applying old interventions in a new setting? Neurodegener Dis Manag 3:1–9CrossRef

Orgeta V, McDonald KR, Poliakoff E et al (2015) Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s Disease (Protocol). Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD011961. http://www.cochranelibrary.com

Farzana F, Sreekanth V, Mohiuddin MK et al (2015) Can individual home-based cognitive stimulation therapy benefit Parkinson’s patients with mild to moderate cognitive impairment? Int J Geriatr Psychiatry 30:433–435CrossRefPubMed

McCormick SA, McDonald KR, Vatter S et al (2017) Psychosocial therapy for Parkinson’s-related dementia: intervention development. Clin Interv Aging. https://doi.org/10.2147/CIA.S143006 CrossRefPubMedPubMedCentral

10.

Craig P, Dieppe P, Macintyre S et al (2008) Developing and evaluating complex interventions: new guidance. BMJ 337:a1655. https://doi.org/10.1136/bmj.a1655 CrossRefPubMedPubMedCentral

11.

Lichstein KL, Riedel BW, Grieve R (1994) Fair tests of clinical trials: a treatment implementation model. Adv Behav Res Ther 16:1–29. https://doi.org/10.1016/0146-6402(94)90001-9 CrossRef

12.

Leroi I, Vatter S, Carter L-A et al (2019) Parkinson's-adapted Cognitive Stimulation Therapy: a pilot randomised controlled clinical trial. Therapeutic Adv Neurological Disorders (in press)

13.

Mccormick SA, Mcdonald KR, Vatter S et al (2017) Psychosocial therapy for Parkinson’s-related dementia: study protocol for the INVEST randomised controlled trial. BMJ Open. https://doi.org/10.1136/bmjopen-2017-016801 CrossRefPubMedPubMedCentral

14.

Moher D, Schulz KF, Altman DG (2001) The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet 357:1191–1194. https://doi.org/10.1016/S0140-6736(00)04337-3 CrossRefPubMed

15.

Litvan I, Goldman JG, Tröster AI et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: movement disorder society task force guidelines. Mov Disord 27:349–356. https://doi.org/10.1002/mds.24893 CrossRefPubMedPubMedCentral

16.

Emre M, Aarsland D, Brown R et al (2007) Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 22:1689–1707. https://doi.org/10.1002/mds.21507 CrossRefPubMed

17.

McKeith IG, Boeve BF, Dickson DW et al (2017) Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB consortium. Neurology 89:88–100. https://doi.org/10.1212/WNL.0000000000004058 CrossRefPubMedPubMedCentral

18.

Fahn S, Elton R (1987) Recent developments in Parkinson’s disease, 2nd edn. Macmilla Health Care Information, Florham Park

19.

Schwab RS, England AC (1969) Projection technique for evaluating surgery in Parkinson’s disease. In: 3rd symposium on Parkinson’s disease, Edinburgh, Livingstone

20.

Nasreddine Z, Phillips N, Bédirian V et al (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695–699. https://doi.org/10.1111/j.1532-5415.2005.53221.x CrossRefPubMed

21.

Charlesworth G, Burnell K, Hoe J et al (2013) Acceptance checklist for clinical effectiveness pilot trials: a systematic approach. BMC Med Res Methodol. https://doi.org/10.1186/1471-2288-13-78 CrossRefPubMedPubMedCentral

22.

Thabane L, Hopewell S, Lancaster GA et al (2016) Methods and processes for development of a CONSORT extension for reporting pilot randomized controlled trials. Pilot Feasibility Stud 2:1–13. https://doi.org/10.1186/s40814-016-0065-z CrossRef

23.

Orsmond GI, Cohn ES (2015) The distinctive features of a feasibility study: objectives and guiding questions. OTJR Occup Particip Health 35:169–177. https://doi.org/10.1177/1539449215578649 CrossRef

24.

Sekhon M, Cartwright M, Francis JJ (2017) Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res 17:1–13. https://doi.org/10.1186/s12913-017-2031-8 CrossRef

25.

Stanniland C, Taylor D (2000) Tolerability of atypical antipsychotics. Drug Saf 22:195–214CrossRefPubMed

26.

Guest G, Bunce A, Johnson L (2006) How many interviews are enough? An experiment with data saturation and variability. Field Methods 18:59–82CrossRef

27.

Julious SA (2005) Sample size of 12 per group rule of thumb for a pilot study. Pharm Stat 4:287–291. https://doi.org/10.1002/pst.185 CrossRef

28.

Onder G, Zanetti O, Giacobini E et al (2005) Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer’s disease: randomised controlled trial. Br J Psychiatry 187:450–455. https://doi.org/10.1192/bjp.187.5.450 CrossRefPubMed

29.

Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101CrossRef

30.

Kiresuk TJ, Sherman RE (1968) Goal attainment scaling: a general method for evaluating comprehensive community mental health programs. Community Ment Health J 4:443–453. https://doi.org/10.1007/BF01530764 CrossRefPubMed

31.

Hsieh S, Schubert S, Hoon C et al (2013) Validation of the Addenbrooke’s cognitive examination III in frontotemporal dementia and Alzheimer’s disease. Dement Geriatr Cogn Disord 36:242–250. https://doi.org/10.1159/000351671 CrossRefPubMed

32.

Spector A, Gardner C, Orrell M (2011) The impact of cognitive stimulation therapy groups on people with dementia: views from participants, their carers and group facilitators. Aging Ment Health 15:945–949CrossRefPubMed

33.

Woods B, Thorgrimsen L, Spector A et al (2006) Improved quality of life and cognitive stimulation therapy in dementia. Aging Ment Health 10:219–226CrossRefPubMed

34.

Bahar-Fuchs A, Clare L, Woods B (2013) Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer’s or vascular type: a review. Alzheimers Res Ther 5:35CrossRefPubMedPubMedCentral

35.

Davies HD, Newkirk LA, Pitts CB et al (2010) The impact of dementia and mild memory impairment (MMI) on intimacy and sexuality in spousal relationships. Int Psychogeriatr 22:618–628CrossRefPubMed

36.

Regan TW, Lambert SD, Girgis A et al (2012) Do couple-based interventions make a difference for couples affected by cancer?: a systematic review. BMC Cancer 12:279CrossRefPubMedPubMedCentral

37.

Yates LA, Leung P, Orgeta V et al (2015) The development of individual cognitive stimulation therapy (iCST) for dementia. Clin Interv Aging 10:95–104PubMed

38.

Weiss EM, Ragland JD, Brensinger CM et al (2006) Sex differences in clustering and switching in verbal fluency tasks. J Int Neuropsychol Soc 12:502–509CrossRefPubMed

39.

Hemmesch AR, Tickle-Degnen L, Zebrowitz LA (2009) The influence of facial masking and sex on older adults’ impressions of individuals with Parkinson’s disease. Psychol Aging 24:542–549CrossRefPubMedPubMedCentral

Title: Parkinson’s-adapted cognitive stimulation therapy: feasibility and acceptability in Lewy body spectrum disorders
Authors: Sheree A. McCormick
Sabina Vatter
Lesley-Anne Carter
Sarah J. Smith
Vasiliki Orgeta
Ellen Poliakoff
Monty A. Silverdale
Jason Raw
David J. Ahearn
Christine Taylor
Joanne Rodda
Tarek Abdel-Ghany
Benjamin Kwapong
Iracema Leroi
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Care
Dementia
Parkinson's Disease
Dementia
Published in: Journal of Neurology / Issue 7/2019
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-019-09329-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Parkinson’s-adapted cognitive stimulation therapy: feasibility and acceptability in Lewy body spectrum disorders

Abstract

Background

Objectives

Methods

Results

Conclusions

Trial registration number

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Objectives

Methods

Results

Conclusions

Trial registration number

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