The Effectiveness of Reality Orientation Therapy in the Treatment of Parkinson Disease Dementia

Patients with Parkinson disease dementia (PDD) have deficits resulting mainly from frontostriatal dysfunction. The aim of this study was to assess the effectiveness of reality orientation therapy (ROT) combined with drug therapy (acetylcholinesterase inhibitors) in PDD treatment and compare it with that of drug therapy alone. Patients (n = 12) with a diagnosis of PDD were divided into 2 groups: group A-drug therapy and ROT; group B-drug therapy alone. Reality orientation therapy was applied weekly for 6 months, and patients were assessed during the same period. Significant improvements in frontostriatal deficits were observed in the group that received the combined therapy, as shown mainly by the scores in verbal fluency in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) battery (P = .02) and in attention in Scales for outcomes of Parkinson's Disease-Cognition (P = .021) and Clock Drawing Test (P = .037). Patients who received only medication had worse results in constructional praxis recall in the CERAD battery (P = .037). Our results indicate that ROT may help in the treatment of frontostriatal cognitive deficits and can potentially be used to complement drug therapy.