Exercise reduces the risk of Parkinson's disease in everyone, regardless of exercise frequency

Previous studies have confirmed that exercise duration has a direct effect on Parkinson's disease (PD); however, the relationship between different types of exercise and the risk of developing PD remains unclear. A recent study published in npj Digital Medicine used data from the UK Biobank to examine the relationship between the risk of developing PD and different exercise regimens.

How does exercise affect the risk of Parkinson's disease?

Parkinson's disease is a neurodegenerative disorder characterized by postural instability, slow movements, muscle tone, and resting tremors. The development of PD can be influenced by factors such as environment, genetic predisposition and lifestyle, including daily exercise.

PD primarily affects people aged 50 years and older. Researchers predict that by 2030, the number of people suffering from PD will reach 8.7-9.3 million worldwide. Thus, given the growing burden of PD, it is critical to identify risk factors at an early stage and develop preventive measures.

Increasing evidence suggests significant benefits of exercise for patients with PD. The World Health Organization recommends at least 150 minutes of moderate-to-vigorous physical activity (MVPA) per week.

Studies have shown similar effectiveness of two specific exercise regimens in reducing the risk of cardiovascular disease and depression. However, the role of specific exercise regimens in reducing the risk of PD has not been studied.

About the study

Researchers have examined the relationship between different exercise regimens and the incidence of PD. Data were collected at 22 sites in Wales, Scotland and England using physical and functional assessments, interviews, questionnaires and biological procedures.

The initial sample included 502,389 people from the UK Biobank. 402,282 people with incomplete exercise data and 1,000 people with pre-existing PD were excluded. An additional 10,607 participants were excluded due to missing data on covariates, resulting in a final sample of 89,400 individuals.

Participants were divided into “inactive” and “active” groups. The "active" group was further subdivided into "weekend warriors" (WW), who exercised one to two days a week, and "regularly active," who exercised throughout the week.

The Axivity AX3 wrist-mounted three-axis accelerometer was used to obtain exercise data. A multivariate Cox model was used to determine the relationship between different exercise regimens and the risk of developing PD.

Research results

During an average follow-up period of 12.32 years, 329 people developed PD. Both WW and regular exercise were significantly associated with a reduced risk of developing PD.

The onset of PD was prevented equally well by evenly distributed exercise time and by using the WW regimen. This observation suggests that duration of exercise may have a greater impact on reducing the risk of PD than frequency of exercise.

Subgroup analyzes were conducted for five covariates, including drinking status, gender, family history, diabetes, and blood pressure. There were no significant relationships between exercise and these factors.

Previously, one study reported that higher levels of exercise may reduce the risk of PD in men, but not in women. In contrast, another US study documented the beneficial effects of exercise on the risk of PD in both men and women. Current studies have also shown a similarly reduced risk of PD in physically active men and women compared with inactive ones.

Restrictions

A key limitation of this study is that UK Biobank only recorded one week of exercise data for each participant. Because repeated measurements were not taken, it is possible that participants' behavioral patterns changed during the week of observation and this may not reflect their actual activity patterns, which is called the Hawthorne effect.

Another limitation is the use of the Axivity AX3 device, which cannot accurately capture exercise data for certain activities, resulting in measurement errors.

The UK Biobank cohort is predominantly made up of white participants, and other racial groups are in the minority, which may limit the general applicability of the findings. Thus, additional research in more diverse populations is needed to confirm these observations.

It is also necessary to conduct analyzes to ensure the consistency of movement data obtained using a wrist accelerometer with data obtained by other methods. The small number of PD cases in the current study may have affected the subgroup analyzes for certain covariates, such as ethnicity.