Objective: To examine the physical activity (PA) level in early Parkinson’s disease (PD) patients and its association with non-motor symptoms (NMS).

Background: Lower PA is associated with greater disease severity, gait impairment and increased difficulty in managing daily activities in moderate PD patients. However, its impact on overall NMS in early PD patients is unknown.

Method: 90 participants (75 early PD, 15 controls) underwent the following evaluations as part of the Early Parkinson’s Disease Longitudinal Singapore (PALS) study: (1) Neuropsychological – MMSE, MoCA, visual and auditory memory, executive function, language and visuospatial orientation, (2) non-motor – NMS Scale (NMSS), Hospital Anxiety and Depression Scale (HADS), Fatigue Severity Scale (FSS), Apathy Scale (AS), Geriatric Depression Scale (GDS), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), (3) motor – UPDRS III, and (4) quality of life (QoL) – European QoL 5-Dimensions (EQ-5D). PA level was measured by the PA Scale for the Elderly (PASE) score. Multivariate generalised linear model analyses were used to look at the association of PASE scores with these variables at baseline and 1-year follow-up.

Results: Patients had significantly higher NMSS scores than controls at both baseline (p<.001) and follow-up (p<.001). Patients also had higher depression (p<.01) and motor scores (p<.001), and lower cognition (p<.01) and QoL scores (p<.001) than controls. These differences persisted at follow-up. After controlling for age, gender, ethnicity and education years, higher PASE score was associated with lower depression [HADS-D(F=5.57, p<.05), GDS(F=4.65, p<.05)], lower apathy [AS(F=6.95, p<.05)] and decreased anhedonia in patients [NMSS 7(F=5.33, p<.05)].Higher baseline PA in patients predicted better NMS scores at 1-year follow-up, (˄=.782, F(7,59)=2.36, p<.05). Univariate analyses showed decreased depression [HADS-D(F=5.35, p<.05), GDS(F=5.29, p<.05)], decreased apathy [AS(F=7.43, p<.05)], higher functioning [EQ-5D Utility Index(F=5.66, p<.05)], reduced anhedonia (F=6.77, p<.05), lower anxiety (F=7.31, p<.05) and decreased sexual dysfunction (F=4.26, p<.05).

Conclusion: Higher PA level is associated with lower levels of depression, apathy, anxiety, anhedonia and sexual dysfunction in early PD at 1-year follow-up. Less PA is associated with lower QoL in patients as compared to controls.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/higher-levels-of-physical-activity-is-associated-with-fewer-non-motor-symptoms-in-early-parkinsons-disease-a-1-year-follow-up-study/