PHYSICAL activity was associated with slower Parkinson progression, including reduced motor and cognitive decline, according to findings from a longitudinal cohort study of patients with Parkinson disease.
Researchers evaluated whether different measures of physical activity influenced long term disease outcomes and found consistent associations between greater activity levels and slower progression over time.
The study analysed data from 294 individuals with mild-to-moderate Parkinson disease enrolled between January 2019 and February 2025.
Physical activity was assessed through standardised interviews and measured using total physical activity time, total physical activity volume, and vigorous physical activity time.
Researchers examined associations between these measures and annual changes in motor function and cognitive performance.
Participants had a mean age of 66.4 years, and 33.0% were female. Follow up extended for up to 5 years for cognitive assessment and 7 years for motor assessment.
Cognitive outcomes were evaluated using the Montreal Cognitive Assessment, while motor progression was assessed using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III.
Across all measures of physical activity, higher levels were associated with slower cognitive decline and motor progression.
Annual changes in Montreal Cognitive Assessment scores were −0.478 points, −0.090 points, and −0.007 points across the low, middle, and high tertiles of total physical activity time, respectively.
Corresponding annual changes in Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III scores were 0.143, −0.225, and −0.783.
Compared with the lowest physical activity tertile, the highest tertile demonstrated slower cognitive progression and slower motor progression.
These findings suggest that greater engagement in physical activity may provide sustained benefits for both motor and cognitive outcomes.
Further analyses explored whether activity intensity or duration was responsible for the observed associations.
Recent physical activity remained linked to longitudinal changes in cognitive and motor measures even after accounting for physical activity over the previous 10 years.
However, vigorous physical activity was no longer associated with outcomes after adjustment for total physical activity time.
The findings suggest that the benefits associated with moderate-to-vigorous physical activity may be driven primarily by longer activity duration and continued engagement rather than intensity alone.
The researchers noted that the observational design, self-reported physical activity measures, and potential selection bias should be considered when interpreting the results.
Nevertheless, the study highlights physical activity as a potentially important factor influencing Parkinson progression.
Ryu D-W et al. Physical activity and motor and cognitive progression in Parkinson disease: a longitudinal cohort study. Neurology. 2026;107:e218682.
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