Physically active women have lower risk of Parkinson’s disease

Prospective data showed that French women with high levels of physical activity had a lower incidence of Parkinson’s disease with increasing age.

Women aged 49 years and older in the highest quartile of physical activity had a 25% lower risk of subsequent Parkinson’s disease compared with women in the lowest quartile (adjusted HR 0.75, 95% CI 0.63- 0.89, P.<0.001), reported by Alexis Elbaz, M.D., Ph.D., Inserm Research Center, Paris, and co-authors. neurology.

Lag analysis suggested that reverse causation is unlikely to drive this association. Ten years before diagnosis, women with Parkinson’s disease had a faster decline in physical activity than women without Parkinson’s disease, probably due to prodromal symptoms.

Promising drug candidates may one day prevent or delay the onset of clinically apparent Parkinson’s disease, but many are still in early stages of development, said Rana Chahine, M.D. medical doctor pointed out. PhD, Radboud University Medical Center, Nijmegen, The Netherlands.

“In contrast, a promising, readily applicable, low-risk approach consists of regular exercise,” Chahine and Derwiesh write in their paper. Accompanying editorial.

of park in shape and Sparks A study in people with Parkinson’s disease showed that exercise could stabilize motor symptoms, which the researchers noted could be symptomatic.a Meta-analysis of observational data found an association between increased physical activity and decreased incidence of Parkinson’s disease, which may have been influenced by reverse causality.

“An approach to minimizing reverse causality in observational studies consists of a lag analysis in which the years of physical activity level data (i.e., ‘lags’) closest to the diagnosis of Parkinson’s disease are omitted.” Editorial writers write. “This approach has not been commonly used in previous studies.”

In addition, Chahine and Darweesh observed that the Parkinson’s disease study on exercise underestimated the proportion of women.

Elbaz et al. used a delayed analysis approach to examine the relationship between physical activity and Parkinson’s disease. E3Nis an ongoing prospective cohort study of 98,995 French women born between 1925 and 1950, recruited in 1990, and covered by national health insurance covering mainly teachers. .

Participants self-reported their physical activity on six questionnaires during the follow-up period.Activity was assessed as time-varying metabolic equivalence task (MET) – Hours per week. Vigorous activity values ​​were above 6 METs and moderate activity values ​​were 3-6 METs depending on intensity.

Parkinson’s disease was self-reported and confirmed by algorithms using medical records or drug claims. Other self-reported data included comorbidities, smoking, diet, and reproductive health.

Mean baseline age was 49 years and mean baseline physical activity level was 45 MET hours/week. The average level for the top quartile was 71 Met hours per week. The bottom quartile was 27.

The researchers incorporated increasing lags of 5, 10, 15, and 20 years between assessments of activity and development of Parkinson’s disease in their analyses. They also assessed activity trajectories in a nested case-control study of 1,196 Parkinson’s disease patients and 23,879 age-matched controls.

The main survival analysis included a 10-year lag. With an average follow-up of 17.2 years, 1,074 women developed Parkinson’s disease. Adjusting for potential confounders, the highest quartile of physical activity showed her 25% lower risk of Parkinson’s disease compared with the lowest. A delay of 15 years gave similar results.

Physical activity decreased with age in both cases and controls, but the decline was more rapid in cases, suggesting decreased activity levels in women with prodromal Parkinson’s disease. The difference in activity levels appeared 29 years before her diagnosis of Parkinson’s disease.

The findings highlight four knowledge gaps, the editors said. How wearable sensors can be used to improve activity monitoring. Mechanisms of activity and potential mediators. And the degree of results varies from person to person.

“The E3N population is confined to French women with a (mainly) professional background in education,” they write. “Future studies are warranted to target samples with diverse demographic and socioeconomic backgrounds.Such knowledge may be useful for tailoring exercise regimens to subgroups at risk for Parkinson’s disease. It can help you with your design.”