BACKGROUND 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. METHODS 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 if 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. RESULTS During an average follow-up of four 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 (HR = 0.79; 95% CI 0.70 - 0.88, p < 0.001). 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. CONCLUSION Older adults with a more active lifestyle have a reduced risk for parkinsonism and a slower rate of its progression.

中文翻译：

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居住在社区中的老年人的每日总体育活动和帕金森氏症的风险。

背景技术体育锻炼是与健康益处相关的可改变的危险因素。我们假设老年人更积极的生活方式与降低帕金森氏病的风险和病情发展的速度减慢有关。方法用活动监测仪记录了889名居住在“拉什记忆与衰老项目”中的社区老年人的日常体育活动。用统一的帕金森氏病评分量表的改良运动部分评估了四个帕金森氏体征，并归纳为一种分类量度和连续的全球帕金森氏评分。我们使用Cox模型确定体育活动是否与突发性帕金森病有关，而线性混合效应模型则检查体育活动是否与进行性帕金森病的发生率有关。结果在平均四年的随访中，没有帕金森病的682名参与者中有233名（34％）发生了帕金森病。在控制年龄，性别和教育程度的Cox模型中，较高的体力活动水平与减少帕金森氏症的风险有关（HR = 0.79； 95％CI 0.70-0.88，p <0.001）。当控制认知，抑郁症状，载脂蛋白EƐ4等位基因和慢性健康状况时，这种联系并没有减弱。在包括所有受年龄，性别和教育程度控制的参与者（N = 889）的线性混合效应模型中，每日总运动量为1 SD与帕金森氏病进展速度降低20％有关。结论具有更积极的生活方式的老年人降低了帕金森氏症的风险，并降低了其发展的速度。