# Cognitive Rehabilitation for Veterans with Parkinson's Disease

> **NIH VA I21** · EDWARD HINES JR VA HOSPITAL · 2022 · —

## Abstract

More than 100,000 US Veterans living with Parkinson's disease (PD) currently receive PD-related care and
services from the VA. In addition to well-defined motor complications, PD is also characterized by progressive
cognitive decline, predominantly executive function (EF) deficits. PD-related cognitive decline is clinically
significant because it leads to long-term functional impairment and diminished quality of life (QoL). Currently,
20-55% of PD patients have mild cognitive impairment (PD-MCI) and up to 80% will develop dementia (PD-
D). Limited treatment options for PD-MCI and PD-D and the possible need to tailor treatments to Veterans
makes cognitive rehabilitation an important VA research topic. Computerized cognitive training (CCT) shows
promise as an effective cognitive rehabilitation approach for geriatric patient populations with cognitive
decline. In PD, emerging evidence reveals cognitive training improves cognition immediately following training
with moderate to large effect sizes on measures of EF. However most studies only included PD patients with
normal cognition (PD-N); only one assessed at-home CCT (with PD-N participants). Thus, no PD studies have
assessed the ability of at-home, CCT programs to improve cognition in PD patients with mild executive
dysfunction (PD-MCI-EF). Moreover, there is paucity in understanding if CCT-induced improvements transfer
to daily activities. This SPiRE seeks to address these gaps by conducting a pilot randomized controlled trial
(RCT) to examine the feasibility of conducting an 8-week at-home cognitive training program using an existing
web-based EF CCT program with or without training in prospective implementation intentions strategies
(PRIIS) in Veterans with PD-MCI-EF. Implementation intention strategies are effective in Alzheimer's disease
and it shows promise in PD patients. PRIIS that builds on cognitive skills trained in CCT and incorporates
prospective memory training that focuses on patient-centered self-management strategies may boost far
transfer effects of CCT. The central hypothesis is that CCT+PRIIS, compared to CCT+PRIIS control or CCT
control+ PRIIS control, will lead to greater improvements in cognitive performance and every day function.
Participants will be randomized to either CCT (four 30min sessions/week) plus PRIIS (implementation
intentions), CCT plus PRIIS control (verbal rehearsal of intentions) or CCT control (entertaining computer
games) plus PRIIS control. The hypothesis is that CCT+PRIIS program will be feasible as indicated by
participant protocol completion rates. Additional information on participants' perception (i.e. enjoyment,
mental stimulation) of the CCT and PRIIS programs will be qualitatively assessed. Participants will also
complete a standardized neurocognitive battery at baseline, endpoint (immediately after 8-week intervention)
and at a 1-month follow-up. The hypothesis is that CCT+PRIIS, compared to other groups, will improve
performance on untrained c...

## Key facts

- **NIH application ID:** 10382207
- **Project number:** 5I21RX003015-03
- **Recipient organization:** EDWARD HINES JR VA HOSPITAL
- **Principal Investigator:** Sandra Lynn Kletzel
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-10-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10382207

## Citation

> US National Institutes of Health, RePORTER application 10382207, Cognitive Rehabilitation for Veterans with Parkinson's Disease (5I21RX003015-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10382207. Licensed CC0.

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