Objective: To determine the association between potentially modifiable factors including (1) cardiovascular risk factors (2) neuropsychiatric symptoms, and (3) sleep quality and progression of motor and cognitive decline in Parkinson’s disease (PD).

Background: There is no disease modifying therapy for PD and symptomatic therapies are focused on dopaminergic pathways, however addressing modifiable comorbidities may influence the rate of progression. Hypertension and a low level of physical activity have been associated with a faster rate of motor and cognitive progression in PD. The relationship between depression and anxiety, and motor and cognitive progression is not well defined. Obstructive sleep apnea (OSA) is associated with cognitive impairment in PD, and treatment of OSA can improve cognition.

Method: Subjects from the Parkinson’s Progression Markers Initiative (PPMI) were examined. Hypertension, hyperlipidemia, smoking, obesity, mood, and sleep quality were evaluated for their effect on motor and cognitive progression in PD subjects. A mixed effect linear regression model will be used to examine the relationship between motor and cognitive progression, and the presence of treatable comorbidities. Group differences in baseline characteristics were analyzed using t tests for continuous variables and chi squared for categorical variables.

Results: Self-reported physical activity was associated with a significant difference in rate of change in the Montreal Cognitive Assessment (MoCA) (p=0.02), controlling for age, sex, Unified Parkinson Disease Rating Scale (UPDRS) part III score, and baseline MoCA.

Conclusion: A higher level of physical activity is associated with slower cognitive decline in PD. We are performing and will present similar analyses with other potentially modifiable factors as described.

References: [1] Amy W. Amara et al., “Self-Reported Physical Activity Levels and Clinical Progression in Early Parkinson’s Disease,” Parkinsonism & Related Disorders, December 2018, https://doi.org/10.1016/j.parkreldis.2018.11.006. [2] Maxime Doiron et al., “The Influence of Vascular Risk Factors on Cognitive Function in Early Parkinson’s Disease: Vascular Risk Factors and Cognition in Early PD,” International Journal of Geriatric Psychiatry 33, no. 2 (February 2018): 288–97, https://doi.org/10.1002/gps.4735. [3] Nadeeka N. W. Dissanayaka et al., “Anxiety Is Associated with Cognitive Impairment in Newly-Diagnosed Parkinson’s Disease,” Parkinsonism & Related Disorders 36 (March 1, 2017): 63–68, https://doi.org/10.1016/j.parkreldis.2017.01.001. [4] Victoria P. Mery et al., “Reduced Cognitive Function in Patients with Parkinson Disease and Obstructive sleep Apnea,” Neurology 88, no. 12 (2017): 1120–1128, https://doi.org/10.1212/WNL.0000000000003738. [5] Marta Kaminska et al., “Change in Cognition and Other Non-Motor Symptoms With Obstructive Sleep Apnea Treatment in Parkinson Disease,” Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine 14, no. 5 (May 15, 2018): 819–28, https://doi.org/10.5664/jcsm.7114.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/modifiable-factors-and-progression-of-motor-symptoms-and-cognitive-decline-in-parkinsons-disease/