Review links lower baseline cognition to greater Parkinson’s intervention gains

A systematic review found that lower cognitive performance before treatment was the most consistent factor associated with greater gains following cognitive intervention in adults with Parkinson’s disease. The analysis included 27 publications involving 835 people with Parkinson’s disease, but substantial methodological limitations and heterogeneity prevented firm conclusions about which characteristics predict treatment responsiveness.

Cognitive dysfunction is among the most disabling non-motor symptoms experienced by people with Parkinson’s disease. Although cognitive interventions may improve cognitive functioning, reported effects are generally small and heterogeneous. The review therefore examined prognostic factors and predictive models associated with responsiveness to cognitive interventions rather than focusing only on their average effects.

The researchers searched MEDLINE, the Web of Science Core Collection and CINAHL through June 2025. Eligible full-text publications were written in English, German or Italian and included adults with Parkinson’s disease, regardless of sex or cognitive status. Studies were required to investigate prognostic factors or predictive models for cognitive or non-cognitive outcomes.

Across the included publications, researchers used 11 approaches for identifying prognostic factors and one factor-finding model. Individual-related factors, including age, education and baseline cognitive performance, were investigated more frequently than intervention-related features such as analogue versus digital delivery. The clearest and most consistent association was between lower baseline cognitive performance and greater gains after cognitive intervention. This was an observed association, not evidence that a particular program will benefit every patient with the same baseline cognitive score.

The findings were synthesized narratively, and methodological quality was assessed with the Quality in Prognosis Studies tool. The risk-of-bias assessment revealed substantial limitations across the literature, while differences among the studies complicated direct comparison of candidate prognostic factors. The authors therefore concluded that determining which characteristics influence responsiveness to cognitive intervention in Parkinson’s disease remains an important research gap.

Subject of Research: Prognostic factors associated with responsiveness to cognitive interventions in adults with Parkinson’s disease

Article Title: Prognostic factors for cognitive intervention responsiveness in Parkinson's disease: a systematic review revealing inconsistent methodology and evidence

Article References: Colucci, A., Berri, M., Ophey, A., Fiorenzato, E., Kalbe, E., & Folkerts, A.-K. (2026). Prognostic factors for cognitive intervention responsiveness in Parkinson's disease: a systematic review revealing inconsistent methodology and evidence. Frontiers in Cognition, 5, Article 1959713. https://doi.org/10.3389/fcogn.2026.1959713

Image Credits: AI Generated

DOI: 10.3389/fcogn.2026.1959713

Keywords: Parkinson’s disease, cognitive intervention, baseline cognition, treatment responsiveness, prognostic factors, predictive models, systematic review, methodological quality, Prognostic, factors, cognitive, intervention