Multidomain cognitive training increases physical activity in people with Parkinson's disease with mild cognitive impairment

Merle Bode; Patricia Sulzer; Claudia Schulte; Sara Becker; Kathrin Brockmann; Saskia Elben; Ann-Kristin Folkerts; Anja Ophey; Christian Schlenstedt; Karsten Witt; Lars Wojtecki; Jordi Evers; Walter Maetzler; Elke Kalbe; Inga Liepelt-Scarfone

doi:10.1016/j.parkreldis.2023.105330

Multidomain cognitive training increases physical activity in people with Parkinson's disease with mild cognitive impairment

Parkinsonism Relat Disord. 2023 Aug:113:105330. doi: 10.1016/j.parkreldis.2023.105330. Epub 2023 Feb 17.

Authors

Affiliations

¹ German Center of Neurodegenerative Diseases (DZNE), Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
² German Center of Neurodegenerative Diseases (DZNE), Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, 2N 1N4, Canada.
³ Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
⁴ Department of Medical Psychology, Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
⁵ Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller-Str. 3, 24105, Kiel, Germany; Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
⁶ Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller-Str. 3, 24105, Kiel, Germany; Department of Neurology and Research Center Neurosensory Sciences, Carl von Ossietzky University Oldenburg, Heiligengeisthöfe 4, 26121, Oldenburg, Germany.
⁷ Department of Neurology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany; Department of Neurology, Hospital Zum Heiligen Geist, Broichhausen-Allee 1, 47906, Kempen, Germany.
⁸ McRoberts B.V., Raamweg 43, 2596, Den Haag, Netherlands.
⁹ Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
¹⁰ German Center of Neurodegenerative Diseases (DZNE), Hertie Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany; IB-Hochschule, Paulinenstr. 45, 70178, Stuttgart, Germany. Electronic address: inga.liepelt@dzne.de.

PMID: 36842867
DOI: 10.1016/j.parkreldis.2023.105330

Abstract

Introduction: Cognitive impairment in Parkinson's disease (PD), especially in patients with mild cognitive impairment (PD-MCI), coincides with less physical activity. Cognitive trainings (CT) have been found to promote laboratory environment-based movement. Knowledge about their effect in natural home-based environment, reflecting everyday function, is sparse. This explorative study investigated short-term effects of CT on physical activity assessed by home-based accelerometry, and its relation to change of cognitive function over time and non-cognitive outcomes in patients with PD-MCI. Cognitive and non-cognitive correlates of movement parameters at pretest were evaluated as well.

Methods: Eighteen patients with PD-MCI of the TrainParC study were analyzed. Those patients received either a 6-week multidomain group CT or physical training (PT). Physical activity and sedentary behavior were assessed with wearable accelerometers worn up to seven days pre- and post-training.

Results: Patients in the CT group displayed significantly greater increases in active periods after training than patients assigned to PT. In the CT group, increases in executive functioning were associated with increases in active periods and decreases in active mean bout length after training. At pretest, reduced working memory correlated with longer sedentary mean bout length, and impairment in activities of daily living (ADL) correlated with a higher number of sedentary periods.

Conclusion: Study data revealed that CT can increase physical activity in patients with PD-MCI, possibly due to effects on executive functions, which needs further investigation in larger sample sizes. Lower working memory performance and ADL impairment might be associated with a more inactive lifestyle in patients with PD-MCI.

Keywords: ADL; Accelerometry; Cognition therapy; Cognitive therapy; Home-based; Mild cognitive impairment; Movement; Natural environment; Parkinson's disease; Physical activity; Sedentary behavior; Wearable.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Cognitive Dysfunction* / psychology
Cognitive Training
Exercise
Humans
Neuropsychological Tests
Parkinson Disease*