2.5 hours of exercise every week may help with mobility in people with Parkinson’s

Patients with Parkinson’s disease may be benefited by 2.5 hours of exercise every week, according to a new study. The American study suggests that exercising for at least 2.5 hours weekly may help Parkinson’s patients maintain physical health and quality of life.

Parkinson’s is a progressive degenerative disease of the central nervous system that mainly affects movement. The condition causes tremors, stiffness of the trunk and limbs, lack of balance and coordination, and mobility deterioration.

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About one million Americans are thought to have Parkinson's, and about 60,000 Americans are diagnosed with the condition each year. Most patients are aged over 50 but younger people can be affected as well.



Past studies have suggested that exercise may benefit patients with Parkinson's. One study found that patients with early Parkinson's who exercised 40 to 60 minutes three times a week experienced improved mobility and balance over 6 months, resulting in a reduction in falls.

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For this study, lead researcher Miriam R. Rafferty, Ph.D., of the Center for Education in Health Sciences at Northwestern University in Chicago, Illinois, and colleagues sought to determine how regular exercise might help health-related quality of life (HRQL), and mobility for Parkinson’s patients over a 2-year period.

They analyzed more than 3,400 patients with Parkinson’s disease. The participants were a part of the National Parkinson Foundation Quality Improvement Initiative (NPF-QII), which gathers data on clinical care and outcomes for Parkinson's patients at 21 places in North America, the Netherlands, and Israel.



Over 2 years, the participants visited the clinic at least three times. During these visits, researchers collected data on the patients’ exercise duration each week, and their functional mobility and HRQL.

The team used Timed Up and Go (TUG) test to assess the participants’ mobility. During the test patients were required to stand up from a seated position, walk about 3 meters, turn around, and then sit back down. Patients self-reported HRQL through The Parkinson Disease Questionnaire (PDQ-39).

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The researchers found that those who took part in a minimum of 2.5 hours of physical exercise a week experienced much slower declines in HRQL and mobility over 2 years, compared with patients who exercised less than 2.5 hours weekly.

"The most important part of the study is that it suggests that people who are not currently achieving recommended levels of exercise could start to exercise today to lessen the declines in quality of life and mobility that can occur with this progressive disease," says Rafferty.



The team also found that patients in the advanced stages of Parkinson's saw an improvement in both HRQL and mobility by increasing their physical activity by 30 minutes each week.

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The team says their findings have far-reaching implications for making Parkinson’s patients more physically active. They note that such patients may experience more severe impairments in their mobility, making participation in current exercise programs challenging.



The study was not intended to pinpoint what types of exercise are best for patients with Parkinson's, but the authors say that performing any type of physical activity is better than being sedentary.

"People with [Parkinson's disease] should feel empowered to find the type of exercise they enjoy, even those with more advanced symptoms," concludes Dr. Rafferty.

Findings of the study were published in the Journal of Parkinson's Disease.

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Chronic Stress Damages Brain, Increases Risk of Dementia

People with chronic stress and anxiety are at an increased risk of developing depression and even dementia, a new research has shown.

When the researchers noticed that mental illness is aggravated by stress, they aimed to address the question of whether anxiety damages the brain and whether they could identify mechanisms behind the connection between stress and mental illness.

For their research, the tem - led by Dr. Linda Mah of the Rotman Research Institute at Baycrest Health Sciences in Canada reviewed animal and human studies that examined brain areas affected by chronic anxiety, fear and stress that are already published. They reported finding "extensive overlap" of the brain's neurocircuitry in all three conditions, which they said may justify the link between chronic stress and the development of neuropsychiatric disorders, including depression and Alzheimer's disease.

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Occasional and temporary fear and stress is normal part of life. This is common among people to feel stressed and anxious before a job interview or an exam. However, when these reactions become chronic or frequent, they can affect daily lives and interfere with work, school and relationships.

Chronic stress is a pathological state. It is caused by stress causing disruption on immune, metabolic and cardiovascular systems, which leads to decay of the brain's hippocampus (crucial for long-term memory and spatial navigation).

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Dr. Linda Mah, clinician scientist with Baycrest's Rotman Research Institute and lead author of the review said:

"Pathological anxiety and chronic stress are associated with structural degeneration and impaired functioning of the hippocampus and the prefrontal cortex (PFC), which may account for the increased risk of developing neuropsychiatric disorders, including depression and dementia.”

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Dr. Mah and colleagues focused on key structures in the neurocircuitry of fear and anxiety – amygdala, medial prefrontal cortex, hippocampus. These brain areas are impacted during chronic stress. The researchers noted similar patterns of abnormal brain activity with fear, anxiety and chronic stress – specifically an overactive amygdala (associated with emotional responses) and an under-active PFC (thinking areas of the brain that help regulate emotional responses through cognitive appraisal).

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This see-saw relationship was first identified in a landmark study by world-renowned neurologist and depression researcher Dr. Helen Mayberg over a decade ago.

However, Dr. Mah also suggests that damage to the hippocampus and PFC as a result of stress can be reversible. She said that both anti-depressant treatment and physical activity have both shown promise in increasing hippocampal neurogenesis.

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The researchers conclude their study by writing:

"Whether anti-anxiety interventions can reduce risk of developing neuropsychiatric illness needs to be established with longitudinal studies."

The paper is posted online this month in the journal Current Opinion in Psychiatry.

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