Exercise can improve non-motor symptoms of PD (hint: mental & cognitive function)

A recent study reminds us that exercise does more than just improve motor symptoms of Parkinson’s Disease, such as tremor, gait disturbances, and postural instability. Exercise can improve non-motor symptoms of Parkinson’s disease, specifically mental and cognitive function.

According to this study:

Up to 57% of patients suffering from PD develop mild cognitive impairment within five years of their initial diagnosis, and if they survive more than ten years, the majority will eventually develop dementia.

This study reviewed earlier studies of exercise and Parkinson’s Disease.

They found 5 studies that had significant group size and included cognitive testing. There was a positive effect of aerobic exercise on memory and executive function. Combined resistance and coordination exercise helped global cognitive function. Two trials showed that coordination exercise led to improved executive function compared with that of non-exercising control subjects.

They concluded:

All modes of exercise are associated with improved cognitive function in individuals with PD. Aerobic exercise tended to best improve memory; however, a clear effect of exercise mode was not identified.

Personally, I hadn’t considered this aspect of exercise. In the short term, people with PD tend to see mobility issues as having the biggest impact on quality of life. But long term, if the majority of us are going to develop dementia, that has a much larger impact on quality of life. This review study is a good reminder on the importance of exercise.

Study press release: https://www.eurekalert.org/pub_releases/2019-03/ip-eci030419.php

Study details: https://www.ncbi.nlm.nih.gov/pubmed/30741688

Cold Turkey – A Dopamine Agonist Withdrawal Syndrome Story

I took more than a year off from updating the Parkinson FIT website…and stopped keeping up with the various PD websites, Twitter, and news feeds. I can’t really say I had a plan, I told myself that I was obsessing a little bit too much about Parkinson’s disease. I figured that I would just go about my life…keeping up the healthier lifestyle and exercise regimen that started after being diagnosed with PD 4+ years ago. All this exercise was time-consuming enough…

All in all, it seemed like a pretty good year…not that different from the year before. This spring, I ran another half marathon, and went on another ski trip…and I get a sense of déjà vu looking at the Parkinson FIT website, and seeing my posts about these same activities the previous spring.

So what brought me back online?

It was my decision two months ago that it was time to stop taking a dopamine agonist (pramipexole/Mirapex).

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Skiing with Parkinson’s Disease

One of the most frustrating things about Parkinson’s Disease is finding yourself unable to do things that you used to enjoy doing. I suppose this applies to aging in general, but with PD, it is premature aging. I was never a great skier, but it was something I enjoyed.

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Running with Parkinson’s Disease – Dreams of Flight

3 years post-PD Diagnosis, Half Marathon completed.

There was a recurring theme in some of my dreams when I was younger…I’d try to run, but despite my best efforts, I was unable to make any forward progress. It was never a situation where I was running away from something, more like I was trying to run toward something. I’d get frustrated, trying to move my legs faster, but I would seem to be running in place. After some period of frustration, it would hit me…I’d remember that I could fly, I just needed to use my arms.

Flying dreams were the best. I’m certain these dreams were inspired by my having watched the Greatest American Hero TV show at an impressionable age. Thankfully, my flights did not require a special form fitting body suit provided by aliens. Let’s face it, even by dream standards, that would be weird.

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Parkinson’s Disease – The Placebo Effect, Genetics and the Placebome

While traveling back home on a long cross country flight, I got a chance to read a fascinating book, “Suggestible You: The Curious Power of Your Brain to Deceive, Transform and Heal” by Erik Vance. The first few chapters are all about the placebo effect, and how some conditions, such as Parkinson’s Disease, are particularly prone to it.

placeboIn a nutshell, the placebo effect is the big challenge in phases 2 & 3 of a clinical trial for a new drug or treatment. In these so-called double blind studies, there is one group that receives the treatment and another group that receives a fake treatment known as the placebo. The patients, and those evaluating the patients do not know who is receiving the real treatment or the placebo until the end of the study. For a treatment to be deemed effective, the patients who received the treatment need to fare better than the placebo group in a statistically significant way. In other words, the treatment being tested has to prove that it’s better than nothing…a challenge that is surprisingly difficult to meet.

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