{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T21:32:34Z","timestamp":1791149554734,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"vor","delay-in-days":322,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000833","name":"Rosetrees Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000833","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000395","name":"Royal College of Physicians","doi-asserted-by":"publisher","award":["RCP-2020\\11"],"award-info":[{"award-number":["RCP-2020\\11"]}],"id":[{"id":"10.13039\/501100000395","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Parkinson's Disease"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Cognitive impairment is common in Parkinson\u2019s disease (PD) but has limited treatment options. Medication has shown some benefits but accompanied by risk of adverse events. We aimed to investigate effectiveness and feasibility of nonpharmacological interventions for people with PD and cognitive impairment on patient\u2010centred outcomes.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Systematic searches of five databases (MEDLINE, Embase, CINAHL, PsycINFO and Web of Science) were performed for studies evaluating nonpharmacological interventions for people with PD and cognitive impairment, reporting health\u2010related quality of life, function (activities of daily living) or wellbeing outcomes, published up to 15 May 2023. Two reviewers independently assessed full\u2010text articles and one reviewer extracted data, with a second reviewer reliability checking all data extraction. Randomised controlled trials (RCTs) were synthesised through meta\u2010analysis using a random\u2010effects meta\u2010analysis with restricted maximum likelihood method pooled estimate and observational studies through narrative synthesis.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Eleven RCTs and three noncontrolled studies were included, studying a range of interventions: cognitive training, cognitive stimulation, cognitive rehabilitation, physical and cognitive exercise, goal management training, psychoeducation with mindfulness, broader rehabilitation programs and a psychological intervention. Feasibility was demonstrated. The majority showed effectiveness for their primary outcome. Meta\u2010analysis showed no significant improvement in HrQoL (seven RCTs: pooled effect, standardised mean difference, \u22120.20 [\u22120.57\u22120.18]) or function (four RCTs: 0.08 [\u22120.36, 0.52]), and wellbeing measurement was infrequent and indirect. Quality of evidence was judged as very low, limiting the conclusions drawn.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Whilst nonpharmacological trials for cognitive impairment in PD have shown promise, we found no evidence of effectiveness on HrQoL, function or wellbeing. However, this is based on very low\u2010quality evidence from a small number of diverse studies, not powered for these outcomes. Feasibility of a range of interventions has been demonstrated in both PD\u2010mild cognitive impairment and PD\u2010dementia. There is a need for more robust, adequately powered studies.<\/jats:p>","DOI":"10.1155\/2024\/3654652","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T18:04:58Z","timestamp":1731953098000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness and Feasibility of Nonpharmacological Interventions for People With Parkinson\u2019s Disease and Cognitive Impairment on Patient\u2010Centred Outcomes"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0951-7941","authenticated-orcid":false,"given":"Jennifer S.","family":"Pigott","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6773-9393","authenticated-orcid":false,"given":"Megan","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9960-2751","authenticated-orcid":false,"given":"Nujhat","family":"Tabassum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7757-5353","authenticated-orcid":false,"given":"Nathan","family":"Davies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9872-6680","authenticated-orcid":false,"given":"Anette","family":"Schrag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2013-000741"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00280-3"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.24893"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21507"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2012.00088"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.05.009"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.69.3.308"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0891988712464823"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2019-322379"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2016.04.009"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0b013e3181a1d44c"},{"key":"e_1_2_10_12_2","unstructured":"National Institute for Health and Care Excellence Parkinson\u2019s Disease in Adults 2017 https:\/\/www.nice.org.uk\/guidance\/ng71."},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2012.00066"},{"key":"e_1_2_10_14_2","article-title":"Cognitive Training for People With Mild to Moderate Dementia (Review)","volume":"25","author":"Bahar-Fuchs A.","year":"2019","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd005562.pub3"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd013388.pub2"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd013572.pub2"},{"key":"e_1_2_10_18_2","article-title":"Cognition-Based Interventions for Healthy Older People and People With Mild Cognitive Impairment (Review)","volume":"19","author":"Martin M.","year":"2011","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_19_2","article-title":"Computerised Cognitive Training for Preventing Dementia in People With Mild Cognitive Impairment (Review)","volume":"13","author":"Gates N.","year":"2019","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2011.02.014"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.3233\/nre-172353"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25377"},{"key":"e_1_2_10_23_2","article-title":"Cognitive Training Interventions for Dementia and Mild Cognitive Impairment in Parkinson\u2019s Disease (Review)","volume":"26","author":"Orgeta V.","year":"2020","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_10_25_2","unstructured":"StataCorp Stata Statistical Software: Release 17 2021 https:\/\/www.stata.com\/stata-news\/news36-2\/."},{"key":"e_1_2_10_26_2","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Sch\u00fcnemann H.","year":"2022"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_10_28_2","first-page":"1","article-title":"Cochrane, Cochrane; 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