Objective: To prospectively examine the associations of physical activity, smoking, caffeine intake, multivitamin use, and adherence to the MIND diet with disease progression among people with Parkinson’s disease (PD).

Background: No intervention is currently recognized to modify PD progression. Lifestyle behaviors such as regular exercise and multivitamin use are believed to improve health in PD, but their effects on disease course remain uncertain.

Method: The study population included 689 women from the Nurses’ Health Study and 755 men from the Health Professionals Follow-up Study who were newly diagnosed with PD during follow-up. Physical activity, smoking, caffeine intake, multivitamin use, and MIND diet adherence were repeatedly assessed using validated questionnaires. Exposures were modeled as cumulative averages from all available questionnaires up to 4 years before PD diagnosis. Mortality and subjective cognitive decline (SCD) served as markers of progression. Mortality was ascertained via the National Death Index and state vital statistics records, and SCD was assessed with seven questions on perceived cognitive changes. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality, and Poisson regression models estimated risk ratios (RRs) and 95% CIs for SCD. Relevant confounders were considered in models.

Results: The mean age at PD diagnosis was 73 years. We documented 768 deaths over 10 years of follow-up. Individuals with PD who were more physically active had a lower risk of death than less active participants. Those spending >2 hours/week in vigorous activity (e.g., running, cycling, lap swimming) had a 21% lower risk of death than those engaging in <0.5 hours/week (HR = 0.79; 95% CI 0.66–0.96). Moderate activity was also associated with reduced mortality (HR for ≥3 vs <1 hours/week = 0.87; 95% CI 0.75–1.00). Higher physical activity was associated with a lower risk of SCD at 10 years (RR = 0.68; 95% CI 0.50–0.93), as was multivitamin use (RR = 0.65; 95% CI 0.52–0.82). Smoking was associated with shorter survival, and caffeine showed no clear association.

Conclusion: This large longitudinal study suggests a protective role of physical activity and multivitamin use in PD progression, highlighting modifiable lifestyle factors as promising targets for intervention.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/lifestyle-factors-as-predictors-of-progression-in-parkinsons-disease/