{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T22:40:26Z","timestamp":1761172826035,"version":"build-2065373602"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004726","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004726","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gender-related differences in cognitive performances of subjects with Parkinson\u2019s Disease and mild cognitive impairment (MCI-PD) have been recently investigated in a few studies, yielding heterogeneous results. Cognitive stimulation (CS) is a promising non-pharmacological treatment in MCI-PD subjects and no data regarding gender differences in its efficacy are available yet. The aim of this study was to investigate gender-related differences in cognitive functions and CS efficacy in subjects with MCI-PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty-five MCI-PD subjects (30 men, 15 women) were randomized to a 4-week CS program, delivered either via tele-rehabilitation (TR) or with a conventional in-person approach. A broad clinical and neuropsychological assessment, including the Cognitive Reserve Index questionnaire, was conducted at baseline (T1), post-treatment (T2), and at 6-month follow-up (T3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, women showed a lower cognitive reserve (CR) compared to men (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.039). After adjusting for CR, women performed worse than men in global cognition, attention, and visuospatial abilities. After CS treatment, men demonstrated significant improvements in global cognition, language, executive functions, working memory, visuospatial abilities, attention, and trait anxiety (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Women showed significant improvements in global cognition (MoCA,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.036) and mood (BDI,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.021). Men outperformed women in several domains, both in TR and in-person rehabilitation groups. Regression models revealed a stronger modulatory effect of CR in global cognition, attention, memory, and language, in women. After a 6-month treatment discontinuation, cognitive performance measures significantly worsened in all subjects, regardless of gender.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study showed gender-related differences both in cognitive functions and in efficacy of CS in subjects with MCI-PD, also highlighting the role of cognitive reserve. These findings support the relevance of developing gender-tailored cognitive rehabilitation strategies to enhance treatment outcomes and improve the quality of life for individuals with MCI-PD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2025.1672084","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:32:45Z","timestamp":1761111165000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Gender-related differences in cognitive performance and cognitive stimulation efficacy in subjects with Parkinson\u2019s disease and mild cognitive impairment"],"prefix":"10.3389","volume":"17","author":[{"given":"Noemi","family":"Iaccino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolanda","family":"Buonocore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giusi","family":"Torchia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Curcio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio M.","family":"Pirrotta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Contrada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loris","family":"Pignolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Gambardella","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gennarina","family":"Arabia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"5695","DOI":"10.1002\/alz.13844","article-title":"Sex and gender differences in cognitive resilience to aging and Alzheimer\u2019s disease","volume":"20","author":"Arenaza-Urquijo","year":"2024","journal-title":"Alzheimers Dement."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1017\/S1355617719001085","article-title":"Sex differences in cognitive changes in De novo Parkinson\u2019s disease","volume":"26","author":"Bayram","year":"2020","journal-title":"J. Int. Neuropsychol. Soc."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"909197","DOI":"10.3389\/fneur.2022.909197","article-title":"Feasibility, safety, and effectiveness of Telerehabilitation in mild-to-moderate Parkinson\u2019s disease","volume":"13","author":"Bianchini","year":"2022","journal-title":"Front. Neurol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"16018","DOI":"10.1038\/npjparkd.2016.18","article-title":"Cognitive decline in Parkinson\u2019s disease: the complex picture","volume":"2","author":"Biundo","year":"2016","journal-title":"NPJ Parkinsons Dis."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1007\/s10072-021-05770-6","article-title":"Cognitive telerehabilitation in neurological patients: systematic review and meta-analysis","volume":"43","author":"Cacciante","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1159\/000117297","article-title":"The mental deterioration battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment","volume":"36","author":"Carlesimo","year":"1996","journal-title":"Eur. Neurol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.parkreldis.2016.02.024","article-title":"Dementia in Parkinson\u2019s disease: is male gender a risk factor?","volume":"26","author":"Cereda","year":"2016","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref9001","doi-asserted-by":"publisher","first-page":"501","DOI":"10.3233\/JPD-191683","article-title":"Parkinson\u2019s disease in women and men: What\u2019s the difference?","volume":"9","author":"Cerri","year":"2019","journal-title":"J Parkinsons Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"64397","DOI":"10.1002\/alz.064397","article-title":"Sex differences in the protective effects of cognitive reserve","volume":"18","author":"Chooi","year":"2022","journal-title":"Alzheimers Dement."},{"key":"ref9002","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1080\/09602010443000074","article-title":"Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer\u2019s disease: a review","volume":"14","author":"Clare","year":"2004","journal-title":"Neuropsychological Rehabilitation"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1097\/PHM.0000000000001745","article-title":"Tele-rehabilitation with virtual reality","volume":"100","author":"Cornejo Thumm","year":"2021","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref9003","doi-asserted-by":"publisher","first-page":"2116","DOI":"10.1016\/j.pec.2018.06.018","article-title":"The impact of the use of video-based educational interventions on patient outcomes in hospital settings: a scoping review","volume":"101","author":"Dahodwala","year":"2018","journal-title":"Patient Educ Couns"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ejim.2016.03.007","article-title":"Frailty measurement in research and clinical practice: a review","volume":"31","author":"Dent","year":"2016","journal-title":"Eur. J. Intern. Med."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1093\/ageing\/afy050","article-title":"The scales of functional assessment of activities of daily living in geriatrics","volume":"47","author":"Devi","year":"2018","journal-title":"Age Ageing"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1621","DOI":"10.1212\/WNL.55.11.1621","article-title":"The FAB","volume":"55","author":"Dubois","year":"2000","journal-title":"Neurology"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/8104673","article-title":"Cognitive stimulation for individuals with Parkinson\u2019s disease dementia living in long-term care: preliminary data from a randomized crossover pilot study","volume":"2018","author":"Folkerts","year":"2018","journal-title":"Parkinsons Dis."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"Mini-mental state","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/S0010-9452(77)80002-6","article-title":"Constructional apraxia in left brain-damaged patients: a planning disorder?","volume":"13","author":"Gainotti","year":"1977","journal-title":"Cortex"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1007\/BF01997792","article-title":"Trail making test: normative values from 287 normal adult controls","volume":"17","author":"Giovagnoli","year":"1996","journal-title":"Ital. J. Neurol. Sci."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2323","DOI":"10.1007\/s10072-021-05772-4","article-title":"Effects of cognitive rehabilitation in Parkinson disease: a meta-analysis","volume":"43","author":"Giustiniani","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1002\/mds.20213","article-title":"Movement disorder society task force report on the Hoehn and Yahr staging scale: status and recommendations the movement disorder society task force on rating scales for Parkinson\u2019s disease","volume":"19","author":"Goetz","year":"2004","journal-title":"Mov. Disord."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement Disorder Society-sponsored revision of the unified Parkinson\u2019s disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov. Disord."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1016\/j.cger.2020.01.001","article-title":"Cognitive impairment and dementia in Parkinson disease","volume":"36","author":"Goldman","year":"2020","journal-title":"Clin. Geriatr. Med."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.exger.2016.12.021","article-title":"Sex differences in frailty: a systematic review and meta-analysis","volume":"89","author":"Gordon","year":"2017","journal-title":"Exp. Gerontol."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"4185","DOI":"10.1007\/s10072-022-05985-1","article-title":"Effect of cognitive reserve on cognitive function in Parkinson\u2019s disease","volume":"43","author":"Gu","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1002\/gps.4284","article-title":"The effects of cognitive reserve and lifestyle on cognition and dementia in Parkinson\u2019s disease\u2014a longitudinal cohort study","volume":"31","author":"Hindle","year":"2016","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1002\/tea.3660270906","article-title":"Gender differences in teacher-student interactions in science classrooms","volume":"27","author":"Jones","year":"1990","journal-title":"J. Res. Sci. Teach."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"7686","DOI":"10.1002\/alz.14236","article-title":"Factors associated with cognitive reserve according to education level","volume":"20","author":"Kim","year":"2024","journal-title":"Alzheimers Dement."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1111\/j.1532-5415.1968.tb02103.x","article-title":"Cumulative illness rating scale","volume":"16","author":"Linn","year":"1968","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1814","DOI":"10.1002\/mds.23823","article-title":"MDS task force on mild cognitive impairment in Parkinson\u2019s disease: critical review of PD-MCI","volume":"26","author":"Litvan","year":"2011","journal-title":"Mov. Disord."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1002\/mds.24893","article-title":"Diagnostic criteria for mild cognitive impairment in Parkinson\u2019s disease: Movement Disorder Society task force guidelines","volume":"27","author":"Litvan","year":"2012","journal-title":"Mov. Disord."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2107","DOI":"10.1212\/WNL.0000000000001609","article-title":"Potential sex differences in nonmotor symptoms in early drug-naive Parkinson disease","volume":"84","author":"Liu","year":"2015","journal-title":"Neurology"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1076\/jcen.25.1.94.13624","article-title":"Relation between clinical characteristics of Parkinson\u2019s disease and cognitive decline","volume":"25","author":"Locascio","year":"2003","journal-title":"J. Clin. Exp. Neuropsychol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"105970","DOI":"10.1016\/j.parkreldis.2023.105970","article-title":"Effectiveness of telerehabilitation plus virtual reality (tele-RV) in cognitive e social functioning: a randomized clinical study on Parkinson\u2019s disease","volume":"119","author":"Maggio","year":"2024","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1017\/S1041610205001547","article-title":"Instrumental activities of daily living scale for dementia screening in elderly people","volume":"17","author":"Mathuranath","year":"2005","journal-title":"Int. Psychogeriatr."},{"key":"ref33","author":"Miceli","year":"1994"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s10072-012-1130-x","article-title":"Forward and backward span for verbal and visuo-spatial data: standardization and normative data from an Italian adult population","volume":"34","author":"Monaco","year":"2013","journal-title":"Neurol. Sci."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"2412","DOI":"10.1212\/WNL.43.11.2412-a","article-title":"The clinical dementia rating (CDR)","volume":"43","author":"Morris","year":"1993","journal-title":"Neurology"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1093\/geront\/29.6.798","article-title":"Application of a multidimensional caregiver burden inventory","volume":"29","author":"Novak","year":"1989","journal-title":"Gerontologist"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"218","DOI":"10.3275\/7800","article-title":"Cognitive reserve index questionnaire (CRIq): a new instrument for measuring cognitive reserve","volume":"24","author":"Nucci","year":"2019","journal-title":"Aging Clin. Exp. Res."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1007\/s00415-021-10728-x","article-title":"Sex differences in brain atrophy and cognitive impairment in Parkinson\u2019s disease patients with and without probable rapid eye movement sleep behavior disorder","volume":"269","author":"Oltra","year":"2022","journal-title":"J. Neurol."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"5411","DOI":"10.1007\/s00415-024-12484-0","article-title":"Mid- and late-life lifestyle activities as main drivers of general and domain-specific cognitive reserve in individuals with Parkinson\u2019s disease: cross-sectional and longitudinal evidence from the LANDSCAPE study","volume":"271","author":"Ophey","year":"2024","journal-title":"J. Neurol."},{"key":"ref9004","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1038\/s41531-020-00121-2","article-title":"Multivariate prediction of dementia in Parkinson\u2019s disease","volume":"6","author":"Phongpreecha","year":"2020","journal-title":"NPJ Parkinson\u2019s Disease"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"554","DOI":"10.23736\/S1973-9087.17.04837-7","article-title":"The impact of cognitive reserve on the effectiveness of balance rehabilitation in Parkinson\u2019s disease","volume":"54","author":"Piccinini","year":"2018","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"105252","DOI":"10.1016\/j.archger.2023.105252","article-title":"Development and implementation of multicomponent homecare interventions for multimorbid and frail older people based on information and communication technologies: the MULTIPLAT_AGE project","volume":"117","author":"Pilotto","year":"2024","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1038\/s41531-020-0109-1","article-title":"Sex specific cognitive differences in Parkinson disease","volume":"6","author":"Reekes","year":"2020","journal-title":"NPJ Parkinsons Dis."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1749","DOI":"10.1093\/arclin\/acac055","article-title":"Improving amnesia diagnostic accuracy with RAVLT single scores and composite indices: Italian normative data","volume":"37","author":"Ricci","year":"2022","journal-title":"Arch. Clin. Neuropsychol."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1159\/000066239","article-title":"On the validity of the Beck depression inventory","volume":"31","author":"Richter","year":"1998","journal-title":"Psychopathology"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1111\/j.1532-5415.2011.03862.x","article-title":"Quality of life as a determinant of frailty phenotype in community-dwelling persons with Parkinson\u2019s disease","volume":"60","author":"Roland","year":"2012","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"429","DOI":"10.3390\/jpm11050429","article-title":"Effectiveness of cognitive rehabilitation in Parkinson\u2019s disease: a systematic review and Meta-analysis","volume":"11","author":"Sanchez-Luengos","year":"2021","journal-title":"J. Pers. Med."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1590\/1980-57642021dn15-010005","article-title":"Impact of cognitive intervention on cognitive symptoms and quality of life in idiopathic Parkinson\u2019s disease: a randomized and controlled study","volume":"15","author":"Sousa","year":"2021","journal-title":"Dement. Neuropsychol."},{"key":"ref49","volume-title":"Theory and research on anxiety. Anxiety and behavior","author":"Spielberger","year":"1966"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.1016\/S1474-4422(12)70191-6","article-title":"Cognitive reserve in ageing and Alzheimer\u2019s disease","volume":"11","author":"Stern","year":"2012","journal-title":"Lancet Neurol."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1016\/j.jalz.2018.07.219","article-title":"Whitepaper: defining and investigating cognitive reserve, brain reserve, and brain maintenance","volume":"16","author":"Stern","year":"2020","journal-title":"Alzheimers Dement."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"2649","DOI":"10.1002\/mds.23429","article-title":"Systematic review of levodopa dose equivalency reporting in Parkinson's disease","volume":"25","author":"Tomlinson","year":"2010","journal-title":"Mov. Disord."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/S0899-9007(98)00171-3","article-title":"The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients","volume":"15","author":"Vellas","year":"1999","journal-title":"Nutrition"},{"key":"ref54","author":"Ware","year":"1992"},{"key":"ref9005","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1159\/000327752","article-title":"Geographic and ethnic variation in Parkinson disease: A population-based study of US Medicare beneficiaries","volume":"36","author":"Willis","year":"2011","journal-title":"Neuroepidemiology"}],"container-title":["Frontiers in Aging Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2025.1672084\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:32:46Z","timestamp":1761111166000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2025.1672084\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,22]]},"references-count":59,"alternative-id":["10.3389\/fnagi.2025.1672084"],"URL":"https:\/\/doi.org\/10.3389\/fnagi.2025.1672084","relation":{},"ISSN":["1663-4365"],"issn-type":[{"value":"1663-4365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,22]]},"article-number":"1672084"}}