Parkinson’s disease risk significantly lower for active men

September 21, 2018

Fudi Wang

Men who engaged in moderate activity significantly reduced their risk for Parkinson’s disease, according to findings recently published in JAMA Network Open.

“Recently, a growing body of evidence has suggested that increased physical activity may also reduce the risk of [Parkinson’s disease],” Xuexian Fang, MD, PhD, of the department of nutrition at Zhejiang University School of Medicine in China, and colleagues wrote.“However, these studies varied with respect to sample size, ethnicity and other characteristics, thereby leading to inconsistencies with respect to their interpretation. In addition, relatively few studies systematically quantified the putative dose-response relationship between physical activity and [Parkinson’s disease] risk.”

Researchers reviewed eight studies consisting of 2,192 patients with Parkinson’s disease and 544,336 patients without the disease. Patients were followed for a median of 12 years.

Fang and colleagues found that men who engaged in moderate to vigorous physical activity significantly reduced their risk for Parkinson’s disease (RR = 0.71; 95% CI, 0.58-0.87). Men who engaged in high levels of physical activity also reduced their risk (RR = 0.79; 95% CI, 0.68-0.91). In addition, each 10 metabolic equivalent of task-hours per week increase in total activity reduced the risk for Parkinson’s disease by 10% and by 17% in those who engaged in moderate to vigorous physical activity.

These benefits were constant in subgroup analyses based on follow-up duration, geographical region, sample size and study quality, but not as prevalent in women and in men who only engaged in light physical activity, according to researchers. 

“These findings may help guide physicians and health care policymakers in making recommendations and developing guidelines with respect to the degree of physical activity that can help reduce the risk of [Parkinson’s disease] at both the individual level and the population level,” Fang and colleagues wrote. “More epidemiological studies with large sample size and detailed quantification of physical activity will help establish more precise information regarding this association.”

Men who engaged in moderate activity significantly reduced their risk for Parkinson’s disease, according to findings recently published in JAMA Network Open.

Study co-author Fudi Wang, MD, PhD, of the department of nutrition at Zhejiang University School of Medicine in China, provided ways for primary care physicians to identify patients at risk for Parkinson’s that would benefit from physical activity.

“To date, the etiology of [Parkinson’s disease] remains an enigma. However, several risk factors have been identified to increase a person’s risk of developing Parkinson’s,” Wang told Healio Family Medicine. 

“It has been previously reported that the incidence of [Parkinson’s disease] is higher in men than women. In our study, we found men are most likely to benefit from moderate to vigorous activity. Aging is a risk factor as the incidence of disease increases with age. It is reported that Parkinson’s disease affects around 1% of the population over the age of 60. These data, together with our findings, suggest that the elderly population could benefit from moderate/vigorous activity to reduce the risk for Parkinson’s disease,” Wang said. 

In a related editorial, Lorene M. Nelson, PhD, of the department of health research and policy at Stanford University School of Medicine, wrote: “The finding that moderate to vigorous physical activity levels were associated with a lower incidence of [Parkinson’s disease] among men meets five of the criteria for establishing causality: strength of association, consistency of findings, temporality, biological gradient (demonstration of dose-response) and biological plausibility.”

According to Nelson, other ideas for future research include re-examining the impact of physical activity on women and their risk for Parkinson’s disease, as well as measuring physical activity with more “relatable metrics” such as the amount of time spent engaged in moderate or vigorous physical activities. – by Janel Miller

PERSPECTIVE

Multiple prior studies support the idea that exercise can reduce the symptoms of Parkinson’s disease in patients who have already received this diagnosis. Fang and colleagues’ meta-analysis may be the first of its kind to determine how exercise affects the risk for developing Parkinson’s disease. Its findings make sense, since people who exercise generally have a host of health benefits, such as being less likely to die from heart attack, diabetes or stroke. 

Though a small percentage of people will acquire Parkinson’s disease from having a family history of the disease, there is currently no way to predict whether most people are at increased risk of developing Parkinson’s disease. Until medical science can find that answer, primary care physicians should see Fang et al’s research as another reason to encourage their patients to engage in a regular exercise program.

Samuel Frank, MD

Associate professor of neurology
Beth Israel Deaconess Medical Center, Boston
Fellow, American Academy of Neurology 

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