Lifetime physical activity influences Parkinson's disease progression

Area of Science:

• Neurology
• Exercise Science
• Public Health

Background:

• Previous research indicates physical activity (PA) post-Parkinson's disease (PD) diagnosis slows motor progression.
• This study investigates the impact of lifetime PA before PD onset on disease progression.

Purpose of the Study:

• To determine if lifetime PA influences motor, cognitive, and functional decline in Parkinson's disease patients.
• To quantify the association between pre-diagnosis PA levels and PD progression markers.

Main Methods:

• Utilized data from 495 participants in the Parkinson's Environment and Gene (PEG) studies.
• Assessed lifetime PA using metabolic equivalents (METs) via interviews.
• Defined PD progression by time to UPDRS-III score ≥ 35, Hoehn and Yahr (H&Y) stage ≥ 3, and MMSE decline, analyzed with Cox frailty models.

Main Results:

• Highest quartile of lifetime strenuous PA (MET-hours/week) correlated with a reduced hazard ratio for reaching UPDRS-III ≥ 35 (HR=0.56).
• Participation in competitive sports (any or high level) significantly lowered the risk of reaching UPDRS-III ≥ 35 (HR=0.61-0.63) and slowed H&Y progression (HR=0.73).
• Lifetime PA did not demonstrate a significant effect on the time to Mini-Mental State Examination (MMSE) decline.

Conclusions:

• Higher levels of lifetime strenuous PA and competitive sports before PD diagnosis are associated with slower motor and overall functional decline.
• Lifetime PA may establish a physical reserve that benefits Parkinson's disease patients.
• Pre-diagnosis physical activity is a potential modifiable factor influencing PD progression.