Association of accelerometer-measured physical activity intensity, sedentary time, and exercise time with incident Parkinson's disease

Abstract

Evidence regarding the association between physical activity and Parkinson's disease (PD) risk is generally limited due to the use of self-report questionnaires. We aimed to quantify the separate and combined effects of accelerometer-measured light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time and exercise timing with incident PD. 96,422 participants without prior PD and with usable accelerometer data were included from UK Biobank. Time spent in sedentary activity, LPA, MVPA, and exercise timing were estimated using machine learning models. The study outcome was incident PD. Over a median follow-up duration of 6.8 years, 313 participants developed PD. There was a L-shaped association for LPA and MVPA, and a reversed L-shaped association for sedentary time, with the risk of incident PD (all P for nonlinearity < 0.001). Similar trends were found across three time-windows (morning, midday-afternoon, and evening). Compared with those with both low LPA (<3.89 h/day) and low MVPA (<0.27 h/day), the adjusted HR (95% CI) of PD risk was 0.49 (0.36-0.66), 0.19 (0.36-0.66) and 0.13 (0.09-0.18), respectively, for participants with high MVPA only, high LPA only, and both high LPA and high MVPA. Moreover, participants with both low LPA and high sedentary time (≥9.41 h/day) (adjusted HR, 5.59; 95% CI: 4.10-7.61), and those with both low MVPA and high sedentary time (adjusted HR, 3.93; 95% CI: 2.82-5.49) had the highest risk of incident PD. In conclusion, regardless of exercise timing (morning, midday-afternoon, and evening), there was an inverse association for accelerometer-measured MVPA and LPA, and a positive association for sedentary time, with incident PD.

Fig. 1. The dose-response association of light and moderate-to-vigorous physical activity and sedentary time with the risk of incident Parkinson’s disease.

There was a nonlinear association of light (a) and moderate-to-vigorous physical activity (b) and sedentary time (c) with the risk of incident Parkinson’s disease. HR indicates hazard ratio. In each plot, the solid line indicates how Parkinson’s disease incidence varies as a function of time spent in physical activity or sedentary behavior, while the dashed lines are confidence intervals. All results were adjusted for age, sex, ethnicities, recruitment center, Townsend Deprivation Index, educational attainment, household income, employment, smoking status, alcohol consumption, and body mass index, pre-existing chronic conditions (hypertension, diabetes and cardiovascular disease), and the season of accelerometer wear.

Fig. 2. The dose-response associations between light and moderate-to-vigorous physical activity and sedentary time within three time-windows and the risk of incident Parkinson’s disease.

There were dose-response associations between light (a–c) and moderate-to-vigorous physical activity (d–f) and sedentary time (g–i) within three time-windows (morning, midday-afternoon, and evening) and the risk of incident Parkinson’s disease. HR indicates hazard ratio. In each plot, the solid line indicates how Parkinson’s disease incidence varies as a function of time spent in physical activity or sedentary behavior, while the dashed lines are confidence intervals. All results were adjusted for age, sex, ethnicities, recruitment center, Townsend Deprivation Index, educational attainment, household income, employment, smoking status, alcohol consumption, and body mass index, pre-existing chronic conditions (hypertension, diabetes and cardiovascular disease), and the season of accelerometer wear.