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Ulanowski E.1, Danzl M.1, Loprinzi P.2, Paydo C.1
1Bellarmine University, Physical Therapy, Louisville, United States, 2University of Mississippi, University, United States
Background: Related to a loss of dopamine cells in the basal ganglia, Parkinson's disease (PD) is the second most common neurodegenerative disease. The hallmark characteristics of PD include bradykinesia, tremor, rigidity, and gait/postural instability. Another feature of PD includes some degree of cognitive impairment, occurring in approximately 5-20% of individuals with PD. Cognition, specifically impaired executive function and dual-tasking, has been linked to recurrent falls and increased falls risk making it vitally important to address in this population. Regular physical activity, including light-to-moderate intensity activity, is associated with improved cognitive function in various populations. Although emerging work is starting to demonstrate physical activity-induced cognitive benefits among those with PD, additional work is needed.
Purpose: The purpose of this study was to examine the association between free-living, accelerometer-assessed physical activity and cognitive function among adults with PD.
Methods: Twenty-five participants with neurologist-confirmed PD were recruited to participate in this study. Participants were recruited from the local community. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive function. After the participants´ cognitive function assessment, participants were asked to wear an ActiGraph GT1M accelerometer during all activities for seven days. All statistical analyses were computed in Stata (v. 12; College Station, TX). Multivariable linear regression analysis was employed to examine the association between moderate-to-vigorous physical activity (MVPA) and cognitive function. Covariates include age, sex, and motor function in PD. The motor function assessment included the Hoehn and Yahr scale, which ranges from 1-5.
Results: Ultimately, 23 of the 25 participants with PD constituted our analytic sample. Participants, on average, were 68.7 years and the sample was equally distributed across sex (56.5% men). With regard to the main findings, and after adjusting for motor impairment (Hoehn and Yahr scale), for every 1 min/day increase in MVPA, participants had a 0.09 unit increase in MoCA-determined cognitive function (β = 0.09; 95% CI: -0.003-0.19; P=0.05). When further adjusting for motor impairment, age and sex, results were unchanged (β = 0.09; 95% CI: 0.004-0.19; P=0.04). When expressed as a larger interval change, for a 10 min/day (sample mean) increase in MVPA, participants had a 1 unit increase in MoCA-determined cognitive function (β = 1.0; 95% CI: 0.04-1.9; P=0.04). Notably, the mean (SE) MVPA among those with normal (≥ 26 MoCA) and abnormal ( 26 MoCA) cognitive function, respectively, was 12.7 min/day and 7.5 min/day.
Conclusion(s): The main finding is that individuals with PD with greater engagement in MVPA had greater cognitive function, as measured by the MoCA test. Notably, this finding persisted even after adjustment for age, sex, and degree of motor impairment. Limitations of the present study include the cross-sectional study design, precluding the ability to establish temporal sequence. Future confirmatory work, particularly studies employing a larger sample are warranted.
Implications: The present study provides suggestive evidence of a favorable association between free-living physical activity behavior and cognitive function among adults with PD. As such, clinicians may wish to promote safe, progressive forms of physical activity to their patients with PD and add education of these findings as a motivation factor.
Funding acknowledgements: No funding was provided for this research.
Topic: Neurology: Parkinson's disease
Ethics approval: Bellarmine Universitys Institutional Review Board approved this research (IRB #360) and informed consent was obtained from each subject.
All authors, affiliations and abstracts have been published as submitted.
