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Multicontext Approach for Cognitive Function in Parkinson Disease

Efficacy and Mechanisms of a Metacognitive Strategy Intervention for Parkinson Disease-Related Cognitive Decline.

Who can join

Ages 50 and older · All sexes

Inclusion criteria:

1. Males and females over age 50 who meet criteria for typical idiopathic PD.
2. Hoehn \& Yahr stage I-III.
3. Have subjective cognitive decline (SCD) as defined by a positive answer to either question:

   * Do you feel like your thinking skills or memory are becoming worse or are worse than others your age?
   * Do you have problems or concerns with your thinking skills or memory?, and can list ≥1 daily cognitive challenge they want to address.
4. Medications should be stable for 4 weeks prior with no changes planned during the treatment portion of the study (Pre to Post); unplanned changes and changes over the follow-up period will be tracked and accounted for as appropriate.

Exclusion criteria:

1. Dementia according to MDS criteria or MoCA score \<21.
2. Other neurological disorders (e.g., stroke, seizures).
3. Current or history of major psychiatric disorder or psychotic symptoms (e.g., schizophrenia, bipolar disorder, delusions, hallucinations), drug abuse. Psychiatric conditions/symptoms that are common in PD (e.g., anxiety, depression) are permitted if deemed insufficient to interfere with participation.
4. Other circumstance that would interfere with participation (e.g., non-English speaking, blindness, lives \>50mi away).

About the study

Mild cognitive decline is common in early Parkinson disease (PD) and is associated with disability, reduced quality of life (QOL), and increased risk for dementia. Medical treatments for PD do not prevent or treat cognitive decline and may even exacerbate the problem.

Unfortunately, existing cognitive interventions for PD, which focus on restoring deficient cognitive skills through cognitive training (repetitive practice of tasks that challenge specific cognitive skills), provide limited benefit for daily function and QOL. To overcome this limitation, the investigators use strategy training. the investigators help people develop targeted strategies to use in everyday life to circumvent cognitive deficits and accomplish daily activities. Contemporary cognitive rehabilitation evidence supports strategy training for other neurological conditions and mild cognitive impairment (MCI), but it has not been well-studied in PD. By teaching strategies for everyday cognition, the investigators hypothesize that our interventions will improve functional outcomes for people with PD.

Study participants will complete a baseline cognitive testing session, 10 cognitive treatment sessions with a trained occupational therapist, then have follow-up visits with the study team at 1-week, 3-months, 6-months, and 12-months after completing the study intervention.

What is being tested

• A metacognitive strategy for cognitive rehabilitation called the Multicontext Approach. (behavioral)
• Cognitive (Process) Training (behavioral)
• MC Approach Booster Session (behavioral)

Sponsor: Washington University School of Medicine · Participants: 114 · Started: May 20, 2026

Contact the study team

• Tasha D Doty, MA · Phone: 785-865-8943
• Erin Foster, PhD · Phone: 314-286-1638

Official record on ClinicalTrials.gov — NCT07190404

Locations in the U.S.

Conditions

• Parkinson's Disease

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.