Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.
J Gerontol A Biol Sci Med Sci. 2020 Mar 9;75(4):702-711. doi: 10.1093/gerona/glz111.
Physical activity is a modifiable risk factor associated with health benefits. We hypothesized that a more active lifestyle in older adults is associated with a reduced risk of incident parkinsonism and a slower rate of its progression.
Total daily physical activity was recorded with an activity monitor in 889 community-dwelling older adults participating in the Rush Memory and Aging Project. Four parkinsonian signs were assessed with a modified motor portion of the Unified Parkinson's Disease Rating Scale and summarized as a categorical measure and continuous global parkinsonian score. We used Cox models to determine whether physical activity was associated with incident parkinsonism and linear mixed-effects models to examine if physical activity was associated with the rate of progressive parkinsonism.
During an average follow-up of 4 years, 233 of 682 (34%) participants, without parkinsonism, developed incident parkinsonism. In Cox models controlling for age, sex, and education, a higher level of physical activity was associated with a reduced risk of developing parkinsonism (hazard ratio = 0.79; 95% CI = 0.70-0.88, p < .001). This association was not attenuated when controlling for cognition, depressive symptoms, Apolipoprotein E ℇ4 allele, and chronic health conditions. In a linear mixed-effects model including all participants (N = 889) which controlled for age, sex, and education, a 1 SD total daily physical activity was associated with a 20% slower rate of progression of parkinsonism.
Older adults with a more active lifestyle have a reduced risk for parkinsonism and a slower rate of its progression.
身体活动是与健康益处相关的可改变的风险因素。我们假设，老年人更活跃的生活方式与帕金森病发病风险降低和疾病进展速度减缓有关。
在参与拉什记忆与衰老项目的 889 名社区居住的老年人中，使用活动监测器记录他们的日常总体力活动。使用统一帕金森病评定量表的改良运动部分评估四项帕金森病体征，并将其总结为分类测量和连续的整体帕金森病评分。我们使用 Cox 模型来确定体力活动与帕金森病发病的关系，以及线性混合效应模型来检验体力活动与进行性帕金森病的进展速度的关系。
在平均 4 年的随访期间，682 名无帕金森病的参与者中，有 233 名（34%）发生了帕金森病发病。在 Cox 模型中，控制年龄、性别和教育程度后，更高水平的体力活动与降低帕金森病发病风险相关（风险比=0.79；95%置信区间为 0.70-0.88，p<0.001）。当控制认知、抑郁症状、载脂蛋白 E ε4 等位基因和慢性健康状况时，这种关联并未减弱。在包括所有参与者（N=889）的线性混合效应模型中，控制年龄、性别和教育程度后，每天总体力活动增加 1 个标准差与帕金森病进展速度减缓 20%相关。
生活方式更活跃的老年人患帕金森病的风险降低，疾病进展速度减缓。
