Association between self-reported physical activity levels and patient reported cognitive problems in Parkinson's disease

Background Cognitive dysfunction is a highly impactful symptom experienced by some people with Parkinson's disease (PD). Physical activity may slow cognitive impairment in PD. Objective Evaluate associations between self-reported physical activity and prevalence and incidence of bothersome cognitive problems, as measured by the PD-Patient Report of Problems (PD-PROP). Methods 22,760 participants in Fox Insight (FI), an online, longitudinal study, completed Physical Activity Scale of the Elderly (PASE) and PD-PROP, a patient-reported outcome measure through which people with PD (PwP) report their 5 most bothersome problems related to PD. Associations between PASE and reports of cognitive problems (classified using a combination of human curation, natural language processing, and machine learning) were evaluated cross-sectionally. 9114 participants with follow-up PD-PROP assessments and no reported cognitive problems at baseline were included in longitudinal analyses to determine if physical activity levels at baseline are associated with incident reporting of cognitive problems. Results At baseline, 32% reported at least one cognitive problem and had lower PASE Leisure scores compared with participants who did not report cognitive problems. Lower levels of physical activity were associated with increased odds of reporting cognitive problems, particularly in categories of memory (OR = 0.913), language/word finding (OR = 0.923), and cognitive impairment not otherwise specified (OR = 0.880). Longitudinally, lower baseline self-reported physical activity levels were associated with incident reporting of cognitive problems, particularly memory impairment. Conclusions Self-reported physical activity levels are modestly associated with both increased prevalence and incident bothersome cognitive problems on the PD-PROP. Due to the subjective nature of these data, results are hypothesis-generating and should not be interpreted as evidence that physical activity prevents cognitive decline.