The Parkinson’s Active Living (PAL) Program

Abstract

The program may hold promise as an effective nonpharmacological intervention for apathy in PD. Implications and future directions are discussed. Randomized controlled trials are needed.

Telepsychiatry for patients with movement disorders: a feasibility and patient satisfaction study

“…Other authors delivered CBT interventions by telephone to PD patients with anxiety and depression, although they did not use videoconferencing [16–19]. The Parkinson’s Active Living program was an innovative behavioral activation intervention for apathy delivered via telehealth to non-demented patients with PD [20]. This program led to significant improvements in apathy and depression, and benefits were maintained one month later [20].…”

“…The Parkinson’s Active Living program was an innovative behavioral activation intervention for apathy delivered via telehealth to non-demented patients with PD [20]. This program led to significant improvements in apathy and depression, and benefits were maintained one month later [20].…”

Apathy Mediates Cognitive Difficulties in Geriatric Depression

“…Indeed, they emphasized that while some pharmacotherapies, including antipsychotics, anticholinergic medications, and psychostimulants have shown some potential benefit, most of the improvements in apathy were found only in combination with nonpharmacological approaches such as exercise, social interaction, or occupational therapy, although these type of studies are sparse. A few formal treatment protocols targeting apathy in Parkinson’s disease and Schizophrenia are beginning to be researched, including interventions involving values clarification, behavioral activation 39 as well as meditation and cognitive restructuring 40 . While promising, these studies require further investigation.…”

Symptom Dimensions of Depression and Apathy and Their Relationship With Cognition in Parkinson’s Disease

“…Subtyping patients with PD based on specific components of depression and apathy may aid in targeting treatment by matching underlying cognitive and brain changes in subgroups of PD with the mechanism of action of pharmacological intervention, such as antidepressants. Moreover, subtyping PD patients may also help to direct non-pharmacological interventions, such that individuals with depression or apathy may be prescribed a course of cognitive behavioral therapy (Berardelli et al, 2015), while those who present with apathy may benefit from treatment that focuses on behavioral activation and incorporates external cuing to counteract the motivation and initiation deficits that are commonly seen (Butterfield et al, 2017). Effective treatment of these specific mood subcomponents may help to alleviate depression- and apathy-related cognitive dysfunction and disability in PD.…”