In this article, we suggest 10 cognitive stimulation exercises for Parkinson’s disease. They are intended for rehabilitation and cognitive stimulation professionals to use with their patients in therapy.
The term Parkinson’s was coined in honor of Dr. James Parkinson, the neurologist who first described the disease in 1817.
What is Parkinson’s disease?
Parkinson’s disease is a chronic, progressive neurodegenerative disease that affects the nervous system. It is a movement disorder and, after Alzheimer’s, the second most common neurodegenerative condition. It is characterized by a lack of dopamine, a neurotransmitter involved in movement, caused by the loss or deterioration of neurons in the substantia nigra. This leads to movement problems such as tremors or loss of postural control.
It’s important to keep in mind that Parkinson’s has no cure and doesn’t affect everyone in the same way. The progression of symptoms, the response to treatment, and the course of the disease are different for each person. That’s why personalized treatment is needed to improve symptoms.
Symptoms of Parkinson’s disease
The symptoms of Parkinson’s disease develop slowly and gradually and get progressively worse over time, making everyday tasks harder. They often begin on one side of the body and later spread to the whole body. Most are motor symptoms, but others can also occur, such as sleep disorders, depression, cognitive changes, or difficulty swallowing. Below are the most common symptoms of Parkinson’s disease.
- Tremors,
- slow movement, or bradykinesia,
- muscle rigidity,
- micrographia, or illegible handwriting,
- balance problems and postural changes,
- excessive saliva production, or sialorrhea,
- hypotonia, or loss of muscle mass,
- impaired fine motor skills,
- speech disorders,
- reduced ability to perform involuntary movements.
Cognitive stimulation exercises for people with Parkinson’s disease
At NeuronUP, we suggest different cognitive stimulation exercises designed to work on the main cognitive processes affected in people with Parkinson’s disease: attention, visuospatial skills, information processing speed, and, above all, executive functioning.
1. Task Sequencing (Picture-Only)
What does it involve?
In this activity, the user has to put in order the different steps needed to carry out an activity.
Activities like this are very useful for stimulating executive functions in people with Parkinson’s disease. Any everyday action can be broken down into different steps for the person to put in order.
In the image, for example, the idea is to number all the steps needed to go shopping in the order in which they naturally happen. There are many versions of this activity, such as using just a list instead of images.
What does this activity do?
Its main function is planning, and its secondary function is reasoning.
2. Knitting a Scarf
What does it involve?
In this activity, the user has to collect all the balls of yarn that appear without crashing into anything.
What does this activity do?
It’s excellent for working on visuospatial skills, sustained attention, and processing speed.
3. Word Association
What does it involve?
Another cognitive stimulation classic, Word Association is an ideal activity for people with Parkinson’s disease.
In the example shown, users have to match the words that are related to each other. Another option is to match images.
What does this activity do?
It works on language, reasoning, and semantic memory.
4. Entangled ropes
What does it involve?
It involves forming a geometric shape by moving its vertices so that none of its sides cross.
What does this activity do?
This activity is better suited to people in the mild or moderate stage of Parkinson’s disease, but it’s very effective for stimulating visuospatial skills. Specifically, it works on spatial visualization and planning.
5. Word Search
What does it involve?
Another classic in stimulation and brain activities: finding the hidden words in a group of letters. It lends itself to many variations: finding certain fruits in a group, words in a single color, or specific symbols.
What does this activity do?
It’s excellent for people with Parkinson’s to work on attention, specifically sustained and selective attention.
Personalization of the activity
NeuronUP lets you customize the words to adapt them to each person, and you can also choose the size and direction of the text. For example, the professional can enter the user’s favorite players or the names of their family members, which is ideal for boosting the user’s motivation when looking for the hidden words.
6. Matching Pairs by Categories
What does it involve?
Here, the idea is to form pairs of words based on a category, for example, a pair of items of clothing.
What does this activity do?
It mainly works on reasoning.
7. Find the Monument
What does it involve?
An activity we’ll probably all end up doing because it’s so motivating. It involves following the directions as quickly as possible until you find the monument within a set time.
What does this activity do?
Of course, it particularly stimulates processing speed.
8. Moving cubes
What does it involve?
This activity involves working out how a set of cubes would look after some of them are moved. It’s designed for people in the mild to moderate stage of Parkinson’s disease.
What does this activity do?
It works especially on spatial visualization and planning.
9. How to get there, simple routes
What does it involve?
After making sure that the people in the group have been familiar with the city they live in for years, we choose two well-known places that they have to travel between mentally, as if they were walking.
The starting point could be, for example, their home, and the destination, the movie theater. Which streets do they need to take? If the participants’ motor impairment isn’t very advanced, we can even ask them to draw a kind of map.
What does this activity do?
This type of exercise lets us work on visuospatial functioning.
10. Repeated words
What does it involve?
This NeuronUP exercise involves pointing out the words that are repeated. For example, in this NeuronUP worksheet, which words are repeated? And how many times is each one repeated? We always stress the need for exercises to be motivating.
What does this activity do?
This activity works on selective attention and working memory.
References on Parkinson’s disease
- Aarsland, D., Bronnick, K., Williams-Gray, C., Weintraub, D., Marder, K., Kulisevsky, J., … Emre, M. (2010). Mild cognitive impairment in Parkinson disease: A multicenter pooled analysis. Neurology., 75(12), 1062–9. Available at https://www.ncbi.nlm.nih.gov/pubmed/20855849
- Reid, W., Hely, M., Morris, J., Loy, C., & Halliday, G. (2011). Dementia in Parkinson’s disease: A 20-year neuropsychological study (Sydney Multicentre study). Journal of neurology, neurosurgery, and psychiatry., 82(9), 1033–7. Available at https://www.ncbi.nlm.nih.gov/pubmed/21335570
- Riedel, O., Rehberg, S. P., Heber, I., Kronenbuerger, M., Schulz, J. B., Storch, A., … Research, P. (2016). Subtypes of mild cognitive impairment in patients with Parkinson’s disease: Evidence from the LANDSCAPE study. Journal of Neurology, Neurosurgery & Psychiatry. doi:10.1136/jnnp-2016-313838
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