Higher levels of physical activity are associated with slower cognitive decline and reduced motor progression in people with mild-to-moderate Parkinson’s disease over periods of up to seven years, according to a longitudinal study published October 7, 2026, in the journal Neurology.
Study Design and Patient Cohort in Cincinnati Research
The study followed nearly 300 people diagnosed with mild to moderate Parkinson’s disease, with an average age of 66. Participants were tracked for up to seven years. Researchers evaluated patients annually using standard cognitive tests scored from zero to 30—where lower scores indicate worse thinking and memory—alongside Parkinson’s symptom assessments scaled from zero to 132, where higher scores denote more severe symptoms.
Participants reported their weekly estimated hours of physical activity through questionnaires covering work, home tasks, and recreational hobbies. Moderate activities included brisk walking, doubles tennis, household vacuuming, mowing the lawn, and window washing. Vigorous activities spanned jogging, fast bicycling, team sports, singles tennis, shoveling, and carrying heavy loads. Alberto Espay, MD, James J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement Disorders Research Endowed Chair in UC’s College of Medicine, noted that the long-term partnership between participants and the research team was the infrastructure behind the longitudinal science that made these multi-year trajectories possible.
Activity Duration Versus Intensity in Parkinson’s Progression
Investigators divided participants into three distinct tiers based on total physical activity time: a low activity group with less than four hours per week, a medium group reporting four to eight hours weekly, and a high group exceeding eight hours of movement per week. The high activity group showed slower cognitive decline and less worsening of movement symptoms when compared to the low group after adjustments for age, sex, disease duration, education, body mass index, and baseline disease stage.
When researchers evaluated activity metrics separately, total activity time remained consistently linked to slower functional declines, whereas vigorous activity on its own showed no association beyond total activity duration.
Annual Score Changes Across Activity Groups
Annual testing revealed clear numerical differences in cognitive and motor trajectories among the three activity cohorts. Participants in the low activity group experienced an average estimated annual decrease in cognitive scores of 0.478 points, compared to a decrease of 0.090 points in the medium group and just 0.007 points in the high group.
On movement symptom evaluations, which started at an average baseline score of 23, the low activity group recorded an average annual score increase of 0.143 points, indicating worsening symptoms. Conversely, the medium group registered an average decrease of 0.225 points, and the high activity group achieved a decrease of 0.783 points. Adjusted statistical models demonstrated that each additional weekly hour of activity correlated with 0.035 fewer points in cognitive decline per year and 0.082 fewer points in motor worsening annually.
Researchers Identify Biological Pathways Linking Exercise to Brain Health
While the findings point toward dual clinical benefits, lead researcher Dong-Woo Ryu, MD, PhD, of the University of Cincinnati emphasized that the research establishes an association rather than direct causation. News & World Report.
Researchers and outside specialists noted several potential biological pathways through which exercise might influence brain health, including enhanced blood flow, reduced inflammation in nerve cells, and enhancing the brain’s ability to change through growth and reorganization. At the same time, investigators acknowledged study limitations, including reliance on self-reported activity data, an observational cohort design, and a participant pool that was predominantly White at 98.3 percent. Further studies are required to determine whether exercise can actively modify disease progression or if patients with slower disease progression simply retain a greater capacity to stay active.
