Greater physical activity associated with slower progression in Parkinson's

by American Academy of Neurology

edited by Sadie Harley, reviewed by Robert Egan

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For people with Parkinson's disease, higher levels of physical activity were associated with slower declines in thinking and memory as well as slower worsening of movement symptoms, according to a new study published in Neurology. The study does not prove that more physical activity causes slower progression of the disease; it only shows an association between the two.

"Parkinson's disease is a brain disorder that causes movement and cognitive problems that gradually worsen, leading to disability and a loss of independence," said study author Dong-Woo Ryu of the University of Cincinnati in Ohio.

"Previous research has shown associations between physical activity and movement symptoms. Our study found physical activity may have dual benefits, with associations with slower declines in movement and cognition."

Tracking activity over seven years

The study included 294 people with mild to moderate Parkinson's disease with an average age of 66. They were followed for up to seven years.

Participants completed questionnaires about their physical activity, reporting estimated weekly hours of physical activity at work, at home and during hobbies or recreational activities. Moderate activity included brisk walking, doubles tennis, light swimming and household activities such as washing windows, vacuuming or mowing the lawn. Vigorous activity included jogging, fast bicycling, team sports and singles tennis as well as shoveling and carrying heavy loads.

Researchers measured the following: total physical activity time, which included both moderate and vigorous exercise; total physical activity volume, a calculation of activity time and intensity, with greater weight given to vigorous activities; and vigorous physical activity time.

For total physical activity time, participants were divided into three groups. The low-activity group had up to four hours per week of activity, the medium-activity group had four to eight hours and the high-activity group had more than eight hours.

Participants were also given annual tests to measure their cognitive abilities and assess their Parkinson's symptoms.

Higher activity linked to slower decline

The cognitive test had a score range of zero to 30, with lower scores indicating worse thinking and memory. Researchers found the low group had an average estimated annual decrease in cognitive scores of 0.478, the medium group had a decrease of 0.090 and the high group had a decrease of 0.007.

The Parkinson's symptom assessment had a score range of zero to 132, with an average score of 23 at the start of the study. Higher scores indicated worse symptoms. For total physical activity, researchers found the low group had an average estimated annual score increase of 0.143, while the medium group had a decrease of 0.225 and the high group had a decrease of 0.783.

After adjusting for age, sex and disease duration, researchers found that the high group showed slower cognitive decline and slower worsening of movement symptoms compared with the low group.

Researchers found that higher values for all three activity measures were each associated with slower cognitive decline and slower worsening of movement symptoms.

Small differences warrant cautious interpretation

"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.

"While our study found small differences between activity levels, these differences may become more meaningful over time. 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."

A limitation of the study was that physical activity was reported by participants, and some people may not have reported their activity accurately.

Publication details

Dong-Woo Ryu et al, Physical Activity and Motor and Cognitive Progression in Parkinson Disease, Neurology (2026). DOI: 10.1212/wnl.0000000000218682

Journal information: Neurology

Key medical concepts

Activities, PhysicalParkinson's DiseaseCognitive Declines

Clinical categories

NeurologyFitness & Physical activity Provided by American Academy of Neurology Who's behind this story?

Sadie Harley

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Robert Egan

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