The Effects of Art Therapy on Executive Functions and Attention in Parkinson's Disease: Systematic Review and...

Art therapies are emerging non-pharmacological complementary treatments for Parkinson's disease (PD). This systematic review and meta-analysis aimed to evaluate their effects on non-motor symptoms, motor symptoms, quality of life (QoL), and activities of daily living (ADLs) in adults aged 50 years and older with PD.

PubMed, Scopus, Cochrane, and Web of Science databases were searched from 2014 to 2025. Of 40 initially identified studies, 33 met inclusion criteria and were included in the review; 24 were incorporated in the meta-analysis using a robust variance estimator to address repeated measurements.

Art therapy was associated with significant improvements in both executive functions [RVE (Mean) = 0.971, 95% CI (0.951, 0.991), Z = 50.323, p < .001] and attention [RVE (Mean) = 0.854, 95% CI (0.834, 0.874), Z = 10.892, p < .001]compared with controls in the follow-up [RVE Mean) = 0.971 95%CI(0.951, 0.991), Z = 50.323, p < .001]. In single-group studies, depressive symptoms decreased post-intervention [RVE (Mean) = 6.289, 95% CI (1.101, 11.477), Z = 10.878, p = .049] but increased again at follow-up [RVE (Mean) = 12.094, 95% CI (0.318, 23.871), Z = 10.878, p = .049] Conversely, outcomes such as freezing of gait, QoL, and PD progression at follow-up favored the control groups rather than the treatment groups.

Evidence suggests that Art therapy may enhance executive functioning - especially at follow-up - and attention in older adults with PD. However, current evidence does not demonstrate consistent benefits in other non-motor or motor outcomes and ADLs. Brief, structured interventions (e.g. 20 sessions of 60 min, twice weekly) administered by dance instructors appear most promising. The improvements observed in control groups further underscore the potential value of active, structured interventions such as exercise or rehabilitation.

Art therapy may serve as a valuable non-pharmacological intervention to support executive functioning and attention in older adults with PD, with improvements observed at follow-up. Single-group studies suggest potential short-term benefits for depressive symptoms, although these effects may not be sustained over time. Structured interventions in high-quality controlled trials, personalized to patient profiles and preferably delivered by specialized professionals, may optimize outcomes. Further research based on high-quality, adequately powered clinical trials is needed to identify the most effective approaches and to determine whether benefits extend beyond cognitive outcomes. Direct comparisons of different art-based modalities may help identify the most effective approaches for improving patient outcomes.