Physical Activity Associated with Reduced Parkinson’s Risk in Women

Highlights

This study used data from E3N (1990–2018), a cohort study involving women enrolled in a national health insurance scheme for people in the education sector. The authors reported that physical activity was associated with a lower risk of Parkinson’s disease (PD) in women.
The main survival analysis included a 10-year lag; During a mean follow-up duration of 17.2 years, 1074 women developed incident PE. After adjustment for potential confounders, there was a 25% lower risk of PD in the highest quartile of physical activity than in the lowest quartile.
This study provides evidence that physical activity is associated with a lower risk of PE in women. Previous cohort studies reported that a single measure of physical activity assessed at baseline was associated with a lower incidence of PD; however, a meta-analysis suggested that this association was restricted to men. This study provides evidence that a sustained increase in overall levels of regular physical activity could be a reasonable general strategy for PD prevention.

SUMMARY

BACKGROUND AND OBJECTIVES

Previous cohort studies reported that a single measure of physical activity (PA) assessed at baseline was associated with a lower incidence of Parkinson’s disease (PD), but a meta-analysis suggested that this association was restricted to men.

Due to the long prodromal phase of the disease, reverse causality could not be excluded as a possible explanation. Our objective was to study the association between time-varying PA and PD using lagged analyzes to address the potential for reverse causality and to compare trajectories of PA in patients before diagnosis and matched controls.

METHODS

We used data from E3N (1990-2018), a cohort study of women enrolled in a national health insurance plan for people working in education. BP was self-reported on six questionnaires during follow-up. As questions changed in the questionnaires, we created a time-varying latent PA (LPA) variable using latent process mixed models. PD was determined using a multi-step validation process based on medical records or a validated algorithm based on medication claims.

We established a nested case-control study to examine differences in ALI trajectories using multivariable linear mixed models with a retrospective time scale. Cox proportional hazards models with age as the time scale and adjusted for confounding factors were used to estimate the association between time-varying LPA and the incidence of PE. Our main analysis used a 10-year lag to account for reverse causality.

RESULTS

Trajectory analyzes (1,196 cases, 23,879 controls) showed that LPA was significantly lower in cases than in controls throughout follow-up, including 29 years before diagnosis; the difference between cases and controls began to increase ∼10 years before diagnosis (P-interaction=0.003).

In our primary survival analysis, of 95,354 PE-free women in 2000, 1074 women developed PE during a mean follow-up of 17.2 years.

The incidence of PE decreased with increasing LPA (P trend = 0.001), with a 25% lower incidence in those in the highest compared to the lowest quartile (adjusted hazard ratio = 0.75, confidence interval 95% = 0.63-0.89). Using longer delays yielded similar conclusions.

CONCLUSIONS

A higher level of physical activity is associated with a lower incidence of Parkinson’s disease in women, which is not explained by reverse causality. These results are important for planning interventions for the prevention of PD.

Physical Activity Associated with Reduced Parkinson’s Risk in Women

Sustained increases in physical activity may serve as a reasonable strategy for preventing Parkinson’s disease in women, according to research findings.