Relationships Between Exercise Frequency, Sex, And Non-motor Symptoms Of Parkinson’s Disease

Parkinson’s disease (PD) is a neurodegenerative disorder primarily diagnosed in older adults. Non-motor symptoms may impact mood, sleep and urination. Exercise can reduce motor symptoms, however, little is known about interactions among exercise, sex and non-motor symptoms. Improved understanding of interactions may allow for tailored exercise recommendations for individuals with PD. PURPOSE: To determine relationships among exercise frequency, sex and non-motor symptoms of PD. METHODS: The Michael J. Fox Foundation maintains survey responses from 50,000+ individuals with PD and controls. The Physical Activity Scale for the Elderly (PASE) leisure subsection evaluates current exercise-specific frequency exclusive of occupational or household activity. High scores indicate more frequent exercise. 25712 men (n = 14319) and women (n = 11392) with PD (65.97 ± 9.73 yrs) completed the PASE and a survey of non-motor PD symptoms. RESULTS: Women with PD had lower PASE leisure subscores than men with PD (women: 40.70 ± 45.78, men: 47.31 ± 49.84, p < .001, t = 10.948). Two-way between-subjects ANOVA revealed a sex by symptom interaction among men and women with PD who experienced vomiting, difficulty emptying bowels, frequent urination, unexplainable changes in weight, difficulty sleeping or excessive sweating (p < .05, F ≥ 4.050). Specifically, men with PD who experienced vomiting, difficulty emptying bowels, changes in weight, difficulty sleeping or excessive sweating had greater reductions in PASE leisure subscore than women with PD (p < .05, F ≥ 4.693). Women with PD who experienced frequent urination had greater reductions in PASE leisure subscore than men with PD (p < .05, F = 4.050) from a lower baseline. CONCLUSION: Exercise frequency of men and women with PD decreases at different rates when experiencing some non-motor symptoms of PD, with men typically experiencing greater decreases in exercise frequency. Future work may investigate if women with PD are more resilient to symptom-induced changes in exercise than men with PD, if exercise type and intensity differs between men and women with PD, or if exercise has a greater impact on non-motor function in men with PD. This information may assist clinicians in identifying individuals at risk for low exercise frequency and proactively encouraging exercise.