Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA.
Neurology. 2010 Jul 27;75(4):341-8. doi: 10.1212/WNL.0b013e3181ea1597.
To prospectively investigate the relationship between physical activity and Parkinson disease (PD).
We evaluated physical activity in relation to PD among 213,701 participants of the NIH-AARP Diet and Health Study cohort. Physical activities over 4 periods (ages 15-18, 19-29, and 35-39, and in the past 10 years) were noted in 1996-1997, and physician-diagnosed PD was reported on the 2004-2006 follow-up questionnaire. Only cases diagnosed after 2000 (n = 767) were included in the analyses.
Higher levels of moderate to vigorous activities at ages 35-39 or in the past 10 years as reported in 1996-1997 were associated with lower PD occurrence after 2000 with significant dose-response relationships. The multivariate odds ratios (OR) between the highest vs the lowest levels were 0.62 (95% CI confidence interval [CI] 0.48-0.81, p for trend 0.005) for ages 35-39 and 0.65 (95% CI 0.51-0.83, p for trend 0.0001) for in the past 10 years. Further analyses showed that individuals with consistent and frequent participation in moderate to vigorous activities in both periods had approximately a 40% lower risk than those who were inactive in both periods. Moderate to vigorous activities at earlier ages or light activities were not associated with PD. Finally, the association between higher moderate to vigorous physical activities and lower PD risk was demonstrated in a metaanalysis of prospective studies.
Although we cannot exclude the possibility that less participation in physical activity is an early marker of PD, epidemiologic evidence suggests that moderate to vigorous exercise may protect against PD.
前瞻性研究体力活动与帕金森病(PD)的关系。
我们评估了 NIH-AARP 饮食与健康研究队列中 213701 名参与者与 PD 相关的体力活动。1996-1997 年记录了 4 个时期(15-18 岁、19-29 岁、35-39 岁和过去 10 年)的体力活动,2004-2006 年的随访问卷报告了医生诊断的 PD。仅纳入了 2000 年后诊断的病例(n=767)进行分析。
1996-1997 年报告的 35-39 岁或过去 10 年中较高水平的中等至剧烈活动与 2000 年后发生 PD 的风险较低相关,且存在显著的剂量反应关系。最高与最低水平之间的多变量比值比(OR)分别为 35-39 岁时为 0.62(95%置信区间[CI]0.48-0.81,趋势检验 p 值=0.005),过去 10 年时为 0.65(95%CI0.51-0.83,趋势检验 p 值=0.0001)。进一步分析表明,在两个时期均持续、频繁参与中等到剧烈活动的个体,其 PD 风险比两个时期均不活动的个体低约 40%。较早时期的中等强度至剧烈活动或轻度活动与 PD 无关。最后,对前瞻性研究的荟萃分析显示,较高的中等强度至剧烈体力活动与较低的 PD 风险相关。
尽管我们不能排除较少参与体力活动是 PD 的早期标志物的可能性,但流行病学证据表明,中等至剧烈运动可能对 PD 具有保护作用。