Older women with Parkinson's disease less physically active, which may worsen outcomes

Key takeaways:

• Women with Parkinson’s disease averaged 98,400 fewer vector magnitude counts a day than those without the disease.
• Patients with Parkinson’s disease should be referred to a physical therapist after diagnosis.

Older women with Parkinson’s disease were less physically active and spent more time being sedentary compared with those without Parkinson’s disease, which may increase their risk for adverse outcomes, according to researchers.

Jennifer L. Hale, PT, DPT, PhD, an associate professor of physical therapy and athletic training at the University of Utah, and colleagues wrote in Preventive Medicine Reports that prior research has established the benefits of moderate-vigorous physical activity (MVPA) in persons with Parkinson’s disease (PD).

However, “our knowledge of movement across the entire intensity spectrum in this population, including time spent in low light-intensity physical activity (LLPA), high-light intensity physical activity (HLPA) and daily sedentary time is insufficient,” they wrote. “As a result, there is a need to characterize physical activity across the intensity spectrum in women with PD.”

To do this, the researchers conducted a cross-sectional analysis on 17,466 ambulatory women who had been enrolled in the Women’s Health Study and wore an accelerometer for 7 days between 2011 and 2015.

In addition to capturing HLPA, LLPA, MVPA and sedentary time statistics, Hale and colleagues also measured total daily physical activity volume through vector magnitude (VM) counts.

Overall, participants had a mean age of 70 years, and 80 had a reported diagnosis of PD at baseline.

Hale and colleagues found that among the cohort, there was a daily average of 511.4 minutes being sedentary, 179.9 minutes in LLPA, 108.4 minutes in HLPA and 91.8 minutes in MVPA.

Compared with those without PD, those with PD averaged:

• 98,400 fewer daily VM counts;
• 23.2 more daily minutes being sedentary;
• 10.5 more daily minutes in LLPA;
• 6.4 fewer daily minutes in HLPA; and
• 27.3 fewer daily minutes in MVPA.

The researchers noted that those with PD “may be particularly vulnerable to worsening disability, as they spend significantly more time sedentary and less time per day in MVPA, which has been shown to be a key ingredient for managing progression of motor symptoms of PD.”

However, the finding that women with PD spent more time in LLPA than in HLPA “suggests a potential shift in the intensity of daily activity, such that women with PD spend less time in the higher end of the intensity spectrum and more time in the lower end of the intensity spectrum,” they added.

“Given what we know about the benefit of time spent in MVPA for this population, future research investigating light intensity physical activity, as either health enhancing or health compromising, should be explored to inform future prevention strategies,” Hale and colleagues wrote.

The study had several limitations, according to the researchers. For example, they were unable to determine PD severity, which could impact PA and sedentary time. The accelerometers were also unable to capture exercises like swimming and biking.

The researchers highlighted currently recommended prevention strategies, such as referring individuals with PD to a physical therapist at the time of diagnosis, with follow-ups every 6 months.

“Prevention strategies to promote physical activity should be emphasized to enhance health and limit progression of disability in this population of women living with PD,” they concluded.