Although the motor symptoms of PD receive the most attention from the medical community, the cognitive deficits are equally debilitating. Approximately 36% of people with PD can be classified as significantly cognitively impaired upon diagnosis. Furthermore, in a study of 115 newly diagnosed PD patients, 100% displayed some deficit in executive function and attention. In addition to impaired executive function and attention, short-term memory deficits are also prominent in PD. As with the motor symptoms of PD, cognitive function deteriorates throughout the course of the disease. Perhaps the most debilitating of these deficits is impaired executive function. Executive function is the ability to plan, schedule and perform complex activities and control impulsive behaviors. Activities that involve executive function range from grocery shopping to responding to unforeseen problems that may arise throughout one’s day. Executive function is also highly involved in many occupations. In addition to the impaired ability to work and carry out essential daily tasks, the lack of impulse control associated with decreased executive function makes social interaction difficult for people with PD. Although decreased attention and impaired short-term memory alone are not debilitating, these deficits exacerbate problems with executive function.
Performing cognitive rehabilitation simultaneously with motor rehabilitation holds the potential to enhance the effects of both modes of therapy. To that end, all patients will perform cognitive exercises on an iPad or computer during recovery time between exercises.