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Exercise may reduce women's Parkinson’s risk, 30-year study finds

Regular exercise might reduce a woman’s chances of developing Parkinson’s disease by as much as 25%, the results of a nearly 30-year study of 95 354 women who did not have the disease when the study began, show.

According to research published in the journal Neurology, researchers compared the women’s physical exercise levels over almost three decades, including such activities as walking, cycling, gardening, stair climbing, house cleaning and sports participation. Their average age was 49.

In that time, 1 074 of them developed Parkinson’s, the study finding that as a woman’s exercise level increased, her risk for Parkinson’s decreased. Those who got the most exercise – based on timing and intensity – developed the disease at a 25% lower rate than those who exercised the least, reports The Washington Post.

The researchers wrote that the study’s findings “suggest that physical activity may help prevent or delay (Parkinson’s disease) onset”.

While the findings are considered an association, study author Dr Alexis Elbaz, a professor at the National Institute of Health and Medical Research in Paris, France, believes this research could help with preventing the disease.

“Exercise is a low-cost way to improve health overall, so our study sought to determine if it may be linked to a lower risk of developing Parkinson’s disease, a debilitating disease that has no cure. Our results provide evidence for planning interventions to prevent the disease.”

Parkinson’s, a neurodegenerative disorder that affects the nervous system and parts of the body controlled by nerves, is sometimes referred to as a movement disorder because of the uncontrollable tremors, muscle stiffness, and gait and balance problems it can cause. Some affected sufferers may also have sleep problems, depression, memory issues, fatigue and more.

The symptoms generally stem from the brain’s lack of production of dopamine, a chemical that helps control muscle movement. No cure exists for Parkinson’s, but treatments to relieve symptoms include medication, lifestyle adjustments and surgical procedures, such as deep brain stimulation.

Most people diagnosed with Parkinson’s are 60 or older. About 500 000 people in the United States have been diagnosed with Parkinson’s, according to the National Institute of Neurological Disorders and Stroke, which notes “the actual number is probably much higher” – perhaps reaching 1m – because so many people are undiagnosed or misdiagnosed.

Study details

Association of Physical Activity and Parkinson Disease in Women: Long-term Follow-up of the E3N Cohort Study

Berta Portugal, Fanny Artaud, Isabelle Degaey,  Emmanuel Roze, Agnes Fournier, Gianluca Severi, Marianne Canonico, Cécile Proust-Lima,  Alexis Elbaz.

Published in Neurology on 30 May 2023

Abstract

Background and Objectives
Previous cohort studies reported that a single measure of physical activity (PA) assessed at baseline was associated with lower Parkinson’s disease (PD) incidence, but a meta-analysis suggested that this association was restricted to men. Due to the long prodromal phase of the disease, reverse causation could not be excluded as a potential explanation. Our objective was to study the association between time-varying PA and PD using lagged analyses to address the potential for reverse causation, and to compare PA trajectories in patients prior to diagnosis and matched controls.

Methods
We used data from E3N (1990-2018), a cohort study of women affiliated with a national health insurance plan for persons working in education. PA was self-reported in six questionnaires over the follow-up. As questions changed across questionnaires, we created a time-varying latent PA (LPA) variable using latent-process mixed models. PD was ascertained using a multistep validation process based on medical records, or a validated algorithm based on drug claims. We set-up a nested case-control study to examine differences in LPA trajectories using multivariable linear mixed models with a retrospective time scale. Cox proportional hazards models with age as the timescale and adjusted for confounders were used to estimate the association between time-varying LPA and PD incidence. Our main analysis used a 10y-lag to account for reverse causation; sensitivity analyses used 5y, 15y, and 20y-lags.

Results
Analyses of trajectories (1,196 cases, 23,879 controls) showed that LPA was significantly lower in cases than in controls throughout the follow-up, including 29y before diagnosis; the difference between cases and controls started to increase ∼10y before diagnosis (P-interaction=0.003). In our main survival analysis, of 95,354 women free of PD in 2000, 1,074 women developed PD over a mean follow-up of 17.2y. PD incidence decreased with increasing LPA (P-trend=0.001), with 25% lower incidence in those in the highest quartile compared to the lowest (adjusted hazard ratio=0.75, 95% confidence interval=0.63-0.89). Using longer lags yielded similar conclusions.

 

Neurology article – Association of Physical Activity and Parkinson Disease in Women: Long-term Follow-up of the E3N Cohort Study (Open access)

 

The Washington Post article – Exercise can cut women’s chances of getting Parkinson’s by 25 percent (Restricted access)

 

See more from MedicalBrief archives:

 

Thousands of Parkinson’s patients initially misdiagnosed

 

Exercise slows early-stage Parkinson’s disease progression

 

Higher antibiotic use may predispose to Parkinson’s disease

 

 

 

 

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