To assess the impact of physical activity on cognitive decline in early Parkinson disease.

Physical activity is an important component of the management of Parkinson disease (PD) and is shown to mitigate cognitive decline among patients with moderate disease. Exercise levels in de novo and early disease may influence risk of future cognitive decline; early disease also presents an opportunity for early intervention and possible disease modification. Physical activity levels in early disease are known to be low, but the impact of activity on cognition is currently unclear.

This study examined PD subjects enrolled in the prospective Parkinson Progression Markers Initiative (PPMI) cohort. At annual study visits, participants completed the Physical Activity Scale for the Elderly (PASE), a validated self-reported questionnaire assessing household, leisure, and work activities over the previous 7 days. We used a linear mixed-effects model to compare rates of change in the Montreal Cognitive Assessment (MoCA) according to PASE scores; co-variates included age, sex, Unified Parkinson Disease Rating Scale (UPDRS) part III score, and baseline MoCA.

379 patients had completed at least one PASE questionnaire over the course of the study. PASE scores in this cohort have been previously described [Mantri S et al. J Park Dis 2018]. Although overall rates of cognitive decline are known to be modest in this early cohort, PASE over time has a significant effect on MoCA during followup (B = 0.000871, p = 0.02) suggesting that higher levels of activity throughout disease are associated with better cognitive performance.

Physical activity is associated with slower cognitive decline in de novo PD patients.