Physical activities and future risk of Parkinson disease.
Level 3 - non-randomized controlled study
Prospective cohort study and meta-analysis of prospective observational studies
PubMed 20660864 · doi:10.1212/WNL.0b013e3181ea1597
What was done
The authors evaluated physical activity across four age periods (ages 15-18, 19-29, 35-39, and the past 10 years) using 1996-1997 baseline questionnaires from 213,701 participants in the NIH-AARP Diet and Health Study cohort. Physician-diagnosed Parkinson disease (PD) was reported on a 2004-2006 follow-up questionnaire. The primary analysis was restricted to 767 cases diagnosed after 2000. A meta-analysis of prospective studies on moderate to vigorous physical activity and PD risk was also conducted.
What was found
Higher levels of moderate to vigorous physical activity were associated with lower PD risk after 2000 with significant dose-response relationships. Multivariate odds ratios (OR) comparing highest versus lowest activity levels were 0.62 (95% CI 0.48-0.81, p for trend = 0.005) for ages 35-39 and 0.65 (95% CI 0.51-0.83, p for trend = 0.0001) for the past 10 years. Individuals with frequent participation in moderate to vigorous activities in both periods had approximately a 40% lower risk than those inactive in both periods. Light activities and moderate to vigorous activities at earlier ages (15-18 and 19-29) were not associated with PD. The meta-analysis of prospective studies also showed an association between higher moderate to vigorous activity and lower PD risk, without numerical values provided in the abstract.
Why it matters
This large prospective investigation indicates that sustained moderate to vigorous exercise in mid-to-late adulthood is associated with a substantially reduced risk of developing Parkinson disease.
Limits
Physical activity across past decades was assessed via retrospective self-report at baseline, introducing potential recall error. PD diagnoses were based on self-reported physician diagnosis. Subclinical or prodromal symptoms may have reduced physical activity prior to diagnosis, so reverse causation cannot be fully ruled out. The abstract omits numerical effect sizes, study counts, and heterogeneity metrics for the meta-analysis.
Cited by
- supports Epidemiological literature demonstrates that greater physical activity is associated with a decreased risk of developing Parkinson's disease.