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Exercise May Slow Cognitive Decline in Some With Early Parkinson Disease

WEDNESDAY, March 31, 2021 -- Increased levels of physical activity may have a protective effect on apolipoprotein E (APOE) ε4-related cognitive decline in early Parkinson disease (PD), according to a study published online March 31 in Neurology.

Ryul Kim, M.D., from Inha University Hospital in Incheon, South Korea, and colleagues used data from the Parkinson's Progression Markers Initiative (PPMI) cohort to examine whether greater physical activity could modify the negative association of APOE ε4 with longitudinal cognitive changes in early PD. Self-reported physical activity was initiated at two years after enrollment and was analyzed longitudinally based on assessments at years 2, 3, and 4. The Montreal Cognitive Assessment was used to measure cognitive function annually.

Data were included for 173 early PD patients (27 percent APOE ε4 carriers). The researchers found that the rate of cognitive decline was steeper with the APOE ε4 allele versus the non-APOE ε4 allele (estimate, −1.33). A significant interaction was identified between physical activity and APOE ε4, with higher physical activity related to slower APOE ε4-related cognitive decline (estimate, 0.007). Regarding changes in striatal dopamine transporter activities, there was no significant interaction between physical activity and the APOE ε4 allele.

"Additional research is needed to confirm our findings, but these results would support the use of interventions that target physical activity as a way to delay cognitive decline in people with early Parkinson's who have the APOE ε4 gene variant," one coauthor said in a statement.

Data used for this study were obtained from the PPMI database; the PPMI is funded by multiple partners, including pharmaceutical companies.

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