Impairments in executive functions (EF) are the core cognitive impairment in patients with Parkinson's disease (PD). Surprisingly, cognitive rehabilitation is not routinely offered to patients with PD. However, in patients with acquired brain injury (ABI), cognitive rehabilitation, in particular strategic executive training, is common practice and has been shown to be effective. In this study, we determined whether PD patients have different needs and aims with regard to strategic executive training than ABI patients, and whether possible differences might be a reason for not offering this kind of cognitive rehabilitation programme to patients with PD. Patients' needs and aims were operationalised by individually set goals, which were classified into domains of EF and daily life. In addition, patients with PD and ABI were compared on their cognitive, in particular EF, profile. Overall, PD patients' goals and cognitive profile were similar to those of patients with ABI. Therefore, based on the findings of this study, there is no reason to assume that strategic executive training cannot be part of standard therapy in PD. However, when strategic executive training is applied in clinical practice, disease-specific characteristics need to be taken into account.

These findings show that objective and subjective measures of EFs are not interchangeable and that both approaches predict level of participation and QoL in patients with PD. However, within this context, sex needs to be taken into account.

Introduction: Motor slowness (bradykinesia) is a core feature of Parkinson's disease (PD). It is often assumed that patients show mental slowness (bradyphrenia) as well; however, evidence for this is debated. The aims of this study were to determine whether PD patients show mental slowness apart from motor slowness and, if this is the case, to what extent this affects their performance on neuropsychological tests of attention, memory, and executive functions (EF). Method: Fifty-five nondemented PD patients and 65 healthy controls were assessed with a simple information-processing task in which reaction and motor times could be separated. In addition, all patients and a second control group (N = 138) were assessed with neuropsychological tests of attention, memory, and EF. Results: While PD patients showed significantly longer reaction times than healthy controls, their motor times were not significantly longer. Reaction and motor times were only moderately correlated and were not related to clinical measures of disease severity. PD patients performed significantly worse on tests of attention and EF, and for the majority of neuropsychological tests 11-51% of the patients showed a clinically impaired performance. Reaction times did not, however, predict patients' test performance, while motor times were found to have a significant negative influence on tests of attention. Conclusions: PD patients show mental slowness, which can be separated from motor slowness. Neuropsychological test performance is not influenced by mental slowness; however, motor slowness can have a negative impact. When interpreting neuropsychological test performance of PD patients in clinical practice, motor slowness needs to be taken into account.

Background Cognitive impairment is often present shortly after transplantation in kidney transplant recipients (KTR). To date, it is unknown whether these impairments persist on the long term, to what extent they are associated with disease related variables and whether they affect societal participation and quality of life (QoL) of KTR. Method This study was part of the TransplantLines Biobank & Cohort study in the University Medical Center Groningen. 131 KTR, with a mean age of 53.6 years (SD = 13.5) transplanted ≥ 1 year ago (M = 11.2 years, range 1–41.7 years), were included, and compared to 306 healthy controls (HC). KTR and HC were well-matched; there were no significant differences regarding age, sex and education. All participants were assessed with neuropsychological tests measuring memory, mental speed, attention and executive functioning, and with questionnaires examining societal participation and QoL. Results Compared to HC, KTR performed significantly worse on memory, mental speed and measures of executive functioning (all p-values < 0.05). Moreover, 16% of KTR met the criteria for mild cognitive impairment (MCI), compared to 2.6% of the HC. MCI in KTR was not significantly correlated with age and disease related variables. Poorer cognitive functioning was significantly related to lower levels of societal participation and to lower QoL (all p-values < 0.01). Conclusions This study shows long-term cognitive impairments in KTR which are not related with disease related variables. Neuropsychological assessment is important to timely signal these impairments, given their serious negative impact on societal participation and QoL.