Telemedicine Intervention to Improve Cognitive Function

Background/Rationale:

Progressive cognitive impairment leading to dementia is an important component of Parkinson's
disease (PD), contributing to significant levels of disability. The number of Veterans who
will develop PD and, in turn, the number of Veterans with PD who develop dementia is likely
to increase substantially. Given the profound negative health and social consequences
associated with the development of dementia, it is critical to identify interventions that
effectively slow the decline of cognitive function to prolong the time to onset of dementia.
Based on the results of prior studies, physical activity is one of the few nonpharmacological
interventions that holds promise in slowing cognitive decline.

Objective:

The investigators hypothesize that a home-based physical activity intervention to promote
walking will reduce cognitive decline in Veterans with mild cognitive impairment in PD
(PD-MCI).

Methods:

The proposed study is a randomized, controlled trial of a home-based walking intervention,
evaluating effects on cognitive function. Community-dwelling Veterans with PD-MCI will be
randomized to a walking intervention or a health education control intervention. Subjects
will be male and female Veterans with a physician diagnosis of idiopathic, typical PD, with
at least 2 of 3 cardinal signs of PD, response to dopaminergic medication, and MCI. The
interventions will last 18 months.

Inclusion Criteria:

- Physician diagnosis of idiopathic, typical Parkinson's disease (PD)

- At least 2 of 3 cardinal signs of PD

- Response to dopaminergic medication

- Mild cognitive impairment

Exclusion Criteria:

- Angina pectoris

- History of myocardial infarction within 6 months

- History of ventricular dysrhythmia requiring current therapy