Cognitive dysfunction in Parkinson's disease contributes to disability, caregiver strain, and diminished quality of life. Cognitive rehabilitation, a behavioral approach to improve cognitive skills, has potential as a treatment option to improve and maintain cognitive skills and increase quality of life for those with Parkinson's disease-related cognitive dysfunction. Four cognitive rehabilitation programs in individuals with PD are identified from the literature. Characteristics of the programs and outcomes are reviewed and critiqued. Current studies on cognitive rehabilitation in PD demonstrate feasibility and acceptability of a cognitive rehabilitation program for patients with PD, but are limited by their small sample size and data regarding generalization of effects over the long term. Because PD involves progressive heterogeneous physical, neurological, and affective difficulties, future cognitive rehabilitation programs should aim for flexibility and individualization, according to each patient's strengths and deficits. 1. Introduction Cognitive dysfunction is a nonmotor feature of Parkinson’s disease (PD) that contributes significantly to disability, caregiver strain, and diminished quality of life over the course of the disease [1, 2]. While there is not a “signature” deficit that characterizes cognitive dysfunction in PD, common features include executive dysfunction, visuospatial dysfunction, and short-term memory deficits. Even in the earliest stages of PD, cognitive decline, and executive dysfunction in particular, is present in up to a third of patients [3]. An estimated 50% of individuals with PD have mild cognitive impairments in the absence of dementia [4, 5], and 25–30% of individuals with PD meet criteria for dementia [6, 7]. With advances in medical and surgical interventions for motor symptoms, individuals with PD are living longer and facing greater disability related to cognitive impairments. Accordingly, there is a corresponding need to address cognitive changes therapeutically. Yet, to date, there are no definitive treatments for cognitive dysfunction in PD [8]. Medication trials, aimed at slowing progression of cognitive decline or improving cognitive performance, have had variable success in decreasing functional impairment [8, 9]. Alternative or adjunctive behavioral interventions for cognitive dysfunction have the potential to reduce disability and improve quality of life in individuals with PD and their caregivers. Originally developed to improve cognitive functioning after traumatic brain injury (TBI), cognitive
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