Objective: To determine whether physical activity (PA) modifies the rate of motor and cognitive progression in Parkinson’s disease (PD) and to identify specific components of PA associated with these effects.
Background: Evidence for the effect of PA on motor and cognitive progression and the specific activity components responsible remains limited.
Method: This longitudinal cohort study analyzed data from individuals with mild to moderate PD enrolled in the Cincinnati Cohort Biomarker Program between Jan 2019 and Feb 2025. MDS-UPDRS-III, Montreal Cognitive Assessment (MoCA) scores, and time spent in moderate-to-vigorous PA were measured at baseline and annually. Associations between total PA time (TPT), total PA volume (TPV), and vigorous PA time (VPT) and longitudinal changes in MoCA and MDS-UPDRS-III scores were examined using linear mixed-effects models. Predicted trajectories of progression were compared across tertiles of TPT. To assess independent effects of activity intensity and timing, we examined residualized VPT (independent of TPT) and residualized recent TPT (independent of prior 10-year TPT).
Results: A total of 294 individuals with PD were included. Significant interactions with time were observed for TPT, TPV, and VPT for MoCA scores (β 0·035 [SE 0·010], p<0·001; 0.006 [0·002], p=0·002; 0·045[0·019], p=0·021) and MDS-UPDRS-III scores (β -0·082 [SE 0·035], p=0·020; -0.014 [0.006], p=0·020; -0·133 [0.064], p=0·039). Annual MoCA change was −0.478 points in the low TPT tertile (0–4 h/week), −0.090 points in the mid tertile (4–8 h/week), and -0.007 points in the high tertile (>8 h/week). Corresponding annual MDS-UPDRS-III change was 0.143, -0.225, and -0.783, respectively. Compared with the low group, the high group showed less decline in MoCA scores (β 0.470 [SE 0.136], p=0.001) and slower progression in MDS-UPDRS-III scores (-0.926 [0.464], p=0.048). The mid group showed less MoCA decline compared with the low group (β 0.387 [SE 0.135], p=0.005). Residualized VPT was not associated with longitudinal changes, whereas residualized recent TPT remained significantly associated with both MoCA and MDS-UPDRS-III change.
Conclusion: Greater total PA time, volume, and vigorous PA were each associated with reduced cognitive decline and slower motor progression in PD, suggesting that PA may be a potentially modifiable factor attenuating motor and cognitive progression in PD.
To cite this abstract in AMA style:
DW. Ryu, KR. Duque, J. Abanto, L. Marsili, NC. Paredes, AH. Gorriti, H. Deraz, E. Hill, A. Duker, AJ. Espay. Physical Activity is Associated with Attenuated Motor and Cognitive Progression in Parkinson’s Disease [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/physical-activity-is-associated-with-attenuated-motor-and-cognitive-progression-in-parkinsons-disease/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/physical-activity-is-associated-with-attenuated-motor-and-cognitive-progression-in-parkinsons-disease/