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Delayed Clinical Manifestation of Parkinson's Disease Among Physically Active: Do Participants in a Long-Distance Ski Race Have a Motor Reserve?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Department of Internal Medicine, Mora hospital, Mora, Sweden.ORCID iD: 0000-0003-2146-7382
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.ORCID iD: 0000-0003-4413-9736
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2020 (English)In: Journal of Parkinson's Disease, ISSN 1877-7171, E-ISSN 1877-718X, Vol. 10, no 1, p. 267-274Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Physical activity is associated with reduced risk of Parkinson's disease (PD). The explanations for this association are not completely elucidated. We use long-term PD-incidence data from long-distance skiers to study the relationship between exercise and PD.

OBJECTIVE: We aimed to investigate if physical activity is associated with long-term lower risk of PD and if this association could be explained by physically active people being able to sustain more PD neuropathology before clinical symptoms, a motor reserve.

METHODS: Using a prospective observational design, we studied whether long-distance skiers of the Swedish Vasaloppet (n = 197,685), exhibited reduced incidence of PD compared to matched individuals from the general population (n = 197,684) during 21 years of follow-up (median 10, interquartile range (IQR) 5-15 years).

RESULTS: Vasaloppet skiers (median age 36.0 years [IQR 29.0-46.0], 38% women) had lower incidence of PD (HR: 0.71; 95 % CI 0.56-0.90) compared to non-skiers. When reducing risk for reverse causation by excluding PD cases within the first five years from race participation, there was still a trend for lower risk of PD (HR: 0.80; 95 % CI 0.62-1.03). Further, the PD prevalence converged between skiers and non-skiers after 15 years of follow-up, which is more consistent with a motor reserve in the physically active rather than neuroprotection.

CONCLUSIONS: A physical active lifestyle is associated with reduced risk for PD. This association weakens with time and might be explained by a motor reserve among the physically active.

Place, publisher, year, edition, pages
IOS Press, 2020. Vol. 10, no 1, p. 267-274
Keywords [en]
Parkinson’s disease, Physical activity, exercise, motor reserve
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-401561DOI: 10.3233/JPD-191762ISI: 000508614100026PubMedID: 31609700OAI: oai:DiVA.org:uu-401561DiVA, id: diva2:1383560
Funder
The Swedish Brain FoundationThe Crafoord FoundationThe Dementia Association - The National Association for the Rights of the DementedStiftelsen Olle Engkvist ByggmästareSwedish Research CouncilAvailable from: 2020-01-08 Created: 2020-01-08 Last updated: 2020-03-09Bibliographically approved

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