- Researchers investigated the impact of physical activity on the progression of cognitive decline and movement-related symptoms in Parkinson’s disease.
- Participants who reported more than 8 hours of physical activity per week had the slowest cognitive decline over 5 years.
- These participants also improved movement-related Parkinson’s symptoms over a follow-up period of 7 years.
A new study, published in Neurologyfound that higher levels of physical activity were associated with slower Parkinson’s disease progression across both cognitive and movement-related symptoms.
Parkinson’s disease is a progressive condition affecting the nervous system. It can cause tremors and changes to the way people move, and in some cases, it can affect memory and the ability to think.
While doctors recommend physical activity to help manage the movement-related symptoms of Parkinson’s disease, they are more likely to try managing cognitive symptoms with medication, therapy, and behavioral management.
“Previous research has shown associations between physical activity and movement symptoms,” said study author Dong-Woo Ryu, MD, PhD, of the University of Cincinnati in Ohio, in a press release.
“Our study found physical activity may have dual benefits, with associations with slower declines in movement and cognition,” Ryu said.
What did the researchers look at?
For the study, the researchers followed 294 people with mild-to-moderate Parkinson’s disease to see how the amount of physical activity they did each week could affect the progression of their symptoms.
The participants had an average age of 66, and around a third were female.
The researchers got the participants to report their physical activity each week, noting how much they did at work, at home, and through hobbies.
They also conducted annual tests to track the progression of participants’ Parkinson’s symptoms over 7 years and their cognitive abilities over 5 years.
“Our study used data from the Cincinnati Cohort Biomarker Program (CCBP), a prospective cohort study,” Ryu explained to Medical News Today.
“Although participants are scheduled for annual follow-up visits, complete data were not always available at every visit. Therefore, the number of participants and the available follow-up periods differed between the cognitive and motor analyses. Importantly, the median follow-up duration was 3 years for both analyses,” he said.
Assessing weekly physical activity
For their analysis, the researchers measured physical activity in three separate ways:
- the total time spent doing any physical activity each week
- the total time spent doing vigorous exercise each week
- the total volume of physical activity done each week, giving greater weight to vigorous exercise
Examples of vigorous exercise included jogging, singles tennis, and carrying heavy loads. In comparison, moderate-intensity exercise included brisk walking, doubles tennis, and household chores like vacuuming and mowing the lawn.
With total physical activity time, the researchers split the participants into three separate groups depending on how much they did each week:
- Low activity: up to 4 hours per week
- Medium activity: 4 to 8 hours per week
- High activity: over 8 hours per week
Higher physical activity levels linked to slower symptom progression
The researchers found that having the highest levels across all three physical activity measures was associated with slower progression of cognitive decline and movement symptoms.
They assessed Parkinson’s symptoms using a scoring system ranging from 0 to 132, with higher scores indicating worse symptoms. At the start of the study, the participants had an average score of 23.
The low-activity group had an estimated annual increase in score of 0.143. However, the medium- and high-activity groups had estimated annual score decreases of 0.225 and 0.783, respectively.
For cognitive decline, the researchers used a scoring system ranging from 0 to 30, with lower scores indicating worse cognitive functioning.
Here, the low-activity group had an estimated annual decrease of 0.478, compared with 0.090 for the medium-activity group and 0.007 for the high-activity group.
Further analysis of the data found that the amount of vigorous activity people engaged in was not associated with long-term outcomes after adjusting for total activity. In short, it was the total amount that participants did that was most important.
How compelling are these findings?
While offering some positivity for people with Parkinson’s disease, there are some limitations to be aware of when interpreting the findings.
“Since participants generally had good thinking and memory skills at the start of the study, our results should be interpreted with caution, and further studies are needed,” Ryu said in the press release.
Another limitation of the study was that participants self-reported their physical activity. This means the accuracy of this information is uncertain, and that participants may have been doing more or less exercise than they recorded.
Finally, as the study was observational, it was unable to account for other factors that may have influenced how the participants’ symptoms progressed.
MNT spoke with Derk W. Krieger, professor of neurology and consultant neurologist at Re:Cognition Health, who was not involved with the study.
“This longitudinal study provides encouraging evidence of an association between greater physical activity and slower cognitive decline. However, reverse causation remains a major concern: patients with milder disease and better preserved cognition may simply be more active,” he said.
“The findings are compelling as an association, but not as proof of disease modification. Exercise should be encouraged as part of comprehensive Parkinson’s care, while randomized trials are needed to establish whether it can genuinely slow neurodegeneration.”
—Derk W. Krieger, consultant neurologist
Differences could be ‘more meaningful’ over time
“The possible benefits of physical activity for people with Parkinson’s disease may depend on how long they stay active and whether they continue exercising over time,” said Ryu, in a press release.
“While our study found small differences between activity levels, these differences may become more meaningful over time,” he continued.
MNT asked Ryu what was next for the team.
“We believe that more evidence is needed to build on our findings,” he said. “Future studies with larger populations and longer follow-up periods could help determine whether these associations remain consistent over time.”
“Imaging and biological biomarkers may also help us better understand the mechanisms underlying the relationship between physical activity and Parkinson’s disease. In addition, advances in digital technology may allow us to monitor physical activity more accurately and develop better ways to maximize its benefits. These technologies could also be valuable tools for future research.”
—Dong-Woo Ryu, MD, PhD, study author
MNT also spoke with Daniel Truong, MD, neurologist and medical director of the Truong Neuroscience Institute at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, who was not involved with the study. He said that exercise was one of the most important non-pharmacological strategies for managing Parkinson’s disease.
“It has both symptom-relieving and potential disease-modifying effects, especially when started early and performed consistently,” he explained.
Truong’s advice for people looking to increase their physical activity includes starting small — “even 10 minutes of mindful movement counts” — choosing something enjoyable, and making it a social activity.
Tracking progress could also help. “Improvements in balance, energy, and mood often appear within weeks,” Truong said.
