Exercise tied to reduced cognitive decline in Parkinson’s patients with APOE4

Reuters Health - 01/04/2021 - People with Parkinson's disease who are carriers of the APOE4 allele have more rapid cognitive decline than non-carriers, but physical activity may still slow the pace of cognitive decline for these patients, a new study suggests.

Researchers examined data on 173 patients with early Parkinson's disease (mean age 63 years), including 46 patients (26.6%) who were carriers of the APOE4 form of the apolipoprotein E gene. Participants completed the Montreal Cognitive Assessment (MoCA) at baseline and then annually, as well as self-reported physical activity assessments at years 2, 3, and 4.

Mean MoCA scores started at 26 points at baseline, and declined by an average of 1.33 points more by the end of the study for APOE4 carriers than for people without this gene variant.

However, APOE4 carriers who had higher physical activity levels at baseline experienced less cognitive decline - an average of 0.007 points less at two years - than their counterparts who were less active, researchers report in Neurology.

"Our results suggest that increased physical activity attenuates APOE e4-related vulnerability to early cognitive decline in patients with Parkinson's disease," said study co-author Dr. Jin-Sun Jun of Kyung Hee University Hospital in Seoul, South Korea.

"Although we cannot conclude what types or amounts of exercise help to slow the progression of Parkinson's disease from this study design, even low-intensity physical activity positively modified the impact of APOE4 on cognitive function," Dr. Jun said by email.

The physical activity questionnaires completed by participants asked about a variety of leisure-time activities performed in the previous week, such as walking, biking, dusting, gardening, or paid or volunteer work.

One limitation of the study is that self-reported activity information is subject to recall bias, and that people experiencing cognitive decline may struggle to accurately report their activity levels, the study team notes.

It's also not clear that physical activity can prevent cognitive decline, what frequency or intensity of which forms of exercise are needed to slow cognitive decline, said Sergio Machado, a neuroscientist at the Salgado de Oliveira University, in Sao Goncalo, Brazil.

"Regarding the effects of physical exercise on existing cognitive decline, several studies show that there is an interruption in the progression of the decline," Machado, who wasn't involved in the study, said by email.

Clinicians should encourage patients with Parkinson's disease to start an exercise routine as soon as they are diagnosed, said Terry Ellis, chair of the department of physical therapy and athletic training and director of the Center for Neurorehabilitation at Boston University.

"Aerobic and resistance exercise have been shown to reduce motor signs of Parkinson's disease," Ellis, who wasn't involved in the study, said by email. "The exercise should be challenging and progressive - at least moderate intensity."

SOURCE: https://bit.ly/3sLsYpv Neurology, online March 31, 2021.

By Lisa Rapaport



Posted on 1 April, 202113 April, 2021