Article

Studies relating to patients with Parkinson disease that assess
neuropsychologic, psychologic, and clinical aspects are very uncommon. OBJECTIVE:
The aim of this study was to analyze the impact of executive functioning
(impaired vs. not impaired) or depression (depressed vs. nondepressed) on the
outcome of rehabilitation treatment in patients with Parkinson disease without
dementia at the medium stage of disease. METHODS: Forty consecutive inpatients
affected by Parkinson disease were psychologically and neuropsychologically
assessed by means of standardized tests during the first week of admission and at
discharge after undergoing an intensive rehabilitation training. RESULTS: At
baseline, the patients (mean [SD] age, 70.1 [8.0]; Mini-Mental State Examination
[MMSE], >/=24) showed impairment in the following executive functions: frontal
functions (32.5%), selective and divided attention (55.0% and 41.9%,
respectively), and word fluency (17.5%). Depressive symptoms reported using the
Geriatric Depression Scale were distributed as follows: mild (n = 13), 32.5%;
moderate (n = 4), 10.0%; and severe (n = 5), 12.5%. As for the outcome of the
intensive rehabilitation treatment, a general improvement in the Unified
Parkinson's Disease Rating Scale, the Berg's scale, the 6-min walking test, and
the Timed Up and Go test was observed (P < 0.0001). The improvement was
homogeneous for all groupings of the patients for all of the considered
variables, indicating that the changes in performance as a result of treatment
were unaffected by the presence of executive function deficits or
moderate-to-severe depression. CONCLUSIONS: The patients' executive function
impairment or moderate-to-severe depressive symptoms did not seem to interfere
with the outcome of the intensive physical and occupational rehabilitation.
Therefore, these aspects in patients without dementia should not be considered a
contraindication to an intensive rehabilitation program. Furthermore, despite the
presence of impaired executive functions and/or of depressive symptoms, the 4-wk
multidisciplinary rehabilitation program resulted to be highly effective.

Langue : ANGLAIS