Tablet-Based Cognitive Stimulation in Parkinson's Disease: What really happens?

Research Objectives: 1) To determine whether a remote tablet-based cognitive intervention program can improve measures of cognition for individuals with Parkinson's Disease (PD).

2) To examine the effects of remote coaching-style support on measures of cognition and adherence.

Design: Dual series of two 4-week tablet-based cognitive intervention in a within-subjects pre-post ABAC/ACAB design (counterbalanced) to assess changes in cognition and adherence in each phase (tablet activity with or without 3x/week meetings) with 2-week hiatus between phases.

Setting: General community

Participants: Target n=12 (n=5 currently). Inclusion: Age 50+, proficiency in English, diagnosis of PD, no other neurological history, vison/hearing corrected to functional, and upper extremity function for tablet use. Exclusions: premorbid cognitive impairment, severe hearing, visual, or upper extremity impairment, concurrent speech therapy.

Interventions: Baseline & Post Testing (A): demographics, Unified Parkinson’s Disease Rating Scale (UPDRS), subtests of Woodcock Johnson Test of Oral Language (WCJTOL) for cognition.

Independent (B): Participants complete cognitive activities (e.g. n-back, pattern replication) using a tablet application using loaned iPads (4 weeks).

Supported (C): Participants complete the identical protocol of Phase B with additional verbal feedback via 10-minute video conference 3x/week (4 weeks).

Main Outcome Measures: Repeated measures analysis of variance with within-subjects factor of intervention phase (B or C) will be used to determine differences in cognitive measures (UPDRS, WCJTOL). Comparative changes in adherence during interventions will also be examined.

Results: Preliminary findings (n=7) for independent tablet activity demonstrate varying adherence (MEAN=18.85/28 days; RANGE 13:26). Participants improved or maintained scores on UPDRS. Average score change in WCJTOL Rapid Picture Naming was 6.6 items (RANGE 4:13); Sentence Repetition average change was 1.16 items (RANGE 1:5). Full analysis will be completed upon full data collection in Summer 2022.

Conclusions: This clinically relevant work aims to determine practical approaches for effective stimulation in the face of service limits. Findings will reveal feasibility and effectiveness of such interventions for people with PD.

Author(s) Disclosures: Funding for this work is through an internal grant by the University Research Council at Seton Hall University. No other relevant disclosures.