Objective: To compare a companion-guided, home-delivered psychosocial stimulation intervention to treatment as usual (TAU) to inform a large-scale efficacy trial for people with cognitive impairment or dementia related to Parkinson’s disease (PD).

Background: Pharmacological treatment for mild-moderate cognitive impairment in people with Parkinson’s related dementia (mild cognitive impairment in PD, or dementia associated with PD or Lewy bodies; PwPDD) is limited and may not be tolerated by some patients. Psychosocial therapies may offer an alternative treatment strategy.

Methods: This is an on-going, single blind, exploratory trial in three UK centres. Participants included PwPDD and their companions (n=128 participants). The intervention was a psychosocial stimulation therapy adapted for PD, guided by trained and protocol-guided companions (3 x 30 minute sessions each week for 10 weeks) compared to TAU. Outcomes include detailed process evaluation of the study procedures, and tolerability/acceptability of the intervention assessed using mixed methods across five dimensions (interest, autonomy, motivation, emotional responses, and mastery).

Results: Interim results revealed excellent recruitment rates with over half (51%) of screened participants being enrolled and willing to be randomised to the TAU group. Attrition rate (30%) was typical for a study of a complex psychosocial intervention in dementia. There were 20 withdrawals (12 experimental, 8 control), and 3 serious adverse events unrelated to the intervention. On a scale of 1-5 (strongly disagree – strongly agree), companions agreed that the PwPDD demonstrated interest (mean 4.2, SD 0.5), autonomy (mean 4.1, SD 0.6), motivation (mean 4.1, SD 0.6), emotional responsivity (mean 3.4, SD 1.0), and mastery (3.8, SD 0.9) during therapy sessions. Participants enjoyed the opportunity to communicate, reminisce and involve others. Some companions reported that the therapy highlighted their partner’s disability. The relation of ratings to indices of outcome will be reported at trial end.

Conclusions: The interim results suggest a large-scale trial of home-based cognitive stimulation therapy is feasible and acceptable. The findings highlight the potential for improving cognition and quality of life of people with Parkinsonian dementia through companion-guided therapy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/feasibility-tolerability-and-acceptance-of-a-psychosocial-intervention-for-people-with-parkinsonian-dementia-the-invest-trial/