Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, United States of America.
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America.
PLoS One. 2020 Apr 29;15(4):e0232404. doi: 10.1371/journal.pone.0232404. eCollection 2020.
We examined the association of physical activity, postmortem brain pathologies, and parkinsonism proximate to death in older adults.
We studied the brains of 447 older decedents participating in a clinical-autopsy cohort study. We deployed a wrist worn activity monitor to record total daily physical activity during everyday living in the community-setting. Parkinsonism was assessed with 26 items of a modified motor portion of Unified Parkinson's Disease Rating Scale (UPDRS). We used linear regression models, controlling for age and sex, to examine the association of physical activity with parkinsonism with and without indices of Alzheimer's disease and related disorders (ADRD) pathologies. In separate models, we added interaction terms to examine if physical activity modified the associations of brain pathologies with parkinsonism.
Mean age at death was 90.9 (SD, 6.2), mean severity of parkinsonism was 14.1 (SD, 9.2, Range 0-59.4), and 350 (77%) had evidence of more than one ADRD pathologies. Higher total daily physical activity was associated with less severe parkinsonism (Estimate, -0.315, S.E., 0.052, p<0.001). The association of more physical activity with less severe parkinsonism persisted after adding terms for ten brain pathologies (Estimate, -0.283, S.E., 0.052, p<0.001). The associations of brain pathologies with more severe parkinsonism did not vary with the level of physical activity.
The association of higher physical activity with less severe parkinsonism may be independent of the presence of ADRD brain pathologies. Further work is needed to identify mechanisms through which physical activity may maintain motor function in older adults.
我们研究了老年人的体力活动、死后大脑病理与接近死亡时帕金森病的关系。
我们研究了 447 名参与临床尸检队列研究的老年死者的大脑。我们使用佩戴在手腕上的活动监测器记录了在社区环境中日常生活中的总日常体力活动。帕金森病采用改良的统一帕金森病评定量表（UPDRS）的运动部分的 26 项进行评估。我们使用线性回归模型，控制年龄和性别，来检查体力活动与帕金森病的关系，同时检查有无阿尔茨海默病和相关疾病（ADRD）病理的指标。在单独的模型中，我们加入了交互项，以检查体力活动是否改变了大脑病理与帕金森病的关系。
死亡时的平均年龄为 90.9（标准差，6.2），帕金森病的平均严重程度为 14.1（标准差，9.2，范围 0-59.4），350 例（77%）有超过一种 ADRD 病理。较高的总日常体力活动与较轻的帕金森病相关（估计值，-0.315，S.E.，0.052，p<0.001）。在加入十种大脑病理的术语后，更多的体力活动与较轻的帕金森病相关仍然存在（估计值，-0.283，S.E.，0.052，p<0.001）。大脑病理与更严重的帕金森病的关联与体力活动水平无关。
更高的体力活动与较轻的帕金森病的关联可能与 ADRD 大脑病理的存在无关。需要进一步的工作来确定体力活动可能维持老年人运动功能的机制。
