About a million people in the U.S. have Parkinson’s disease (PD), with about 60,000 Americans receiving a diagnosis each year. As a scientist focused on developing and testing therapies to help PD patients, over the past 20 years, I realized a lot of older guys were part of my studies. There is a reason for that: The debilitating disease, which is typically diagnosed at age 60 or older, affects 50 percent more men than women. We are still trying to understand why males have a higher incidence than females, but research shows that there is something males (and females) can do to help decrease the risk of developing PD and improve the prognosis should a diagnosis occur: exercise.
The Unique Link Between Parkinson’s and Exercise
First, a quick overview of the disease: Parkinson’s is a disorder that affects your brain and central nervous system. It is caused by a loss of brain cells that produce dopamine, a chemical messenger that helps communicate and coordinate a number of your body’s functions, including movement. PD is degenerative, meaning symptoms (e.g., tremors, unstable balance or slowed movements) worsen over time.
Because PD has a marked effect on your motor abilities, it is perhaps not totally surprising that staying active could help by improving patients’ gait, flexibility and coordination. But exercise does not just offer physical benefits. Research shows that working out can also defend against the neurodegenerative aspects of the disease.
How does it work? For one, getting your heart pumping also gets your neurons pumping. Dancers and athletes often talk about the concept of “muscle memory,” but your muscles do not have “memory” capabilities. So, where do those movements and muscle control come from? The brain.
Exercise elevates levels of neurotrophic factors (proteins in the brain). Proteins help your body repair old cells and generate new ones. That is why we increase the protein in our diet when we want to build muscle. But protein does not just work on quads and biceps. It also slows cell death and promotes the growth of new cells in your brain, including the parts of the brain affected by PD.
By the time a person develops clinical symptoms of PD, they have often already lost between 60 and 80 percent of their dopamine-producing cells. Data suggest exercise can help build a buffer around a patient’s remaining dopamine-producing cells, preserving them and slowing progression of the disease. It may even protect a person from being diagnosed in the first place. Epidemiological studies report that individuals who are active in midlife actually have a decreased incidence of PD.
More Compelling Research on the Horizon
I first made the connection between exercise and PD symptoms nearly 20 years ago. I was cycling across the state of Iowa with a friend who has Parkinson’s, and a few days into the ride, I noticed her handwriting had improved. Since then, I have been studying how exercise can improve outcomes for PD patients.
An exciting trial I am currently involved in is the SPARX3, which stands for Study in Parkinson Disease of Exercise. The study builds on SPARX2, a clinical trial that found that engaging in either a moderate-intensity (60 to 65 percent maximum heart rate, four days a week) or high-intensity (80 to 85 percent maximum heart rate, four days a week) exercise program was safe and effective at reducing the progression of early-onset PD. SPARX3 will be a much larger study, taking place in 29 academic medical centers and universities across North America. The team hopes to further understand the effects of these two levels of exercise intensity on PD progression in those individuals who are newly diagnosed and have not yet begun taking medication.
The data from this and other studies are all pushing to move past the generic maxim “You should exercise.” Using all of this research, we hope to refine and create a precise exercise prescription, so patients can know exactly what they need to do and have insight into the expected benefits. In my experience, individuals with PD are ready to do whatever it takes to protect their health. If we can provide more specific recommendations, I believe they will stick with it.
While You Wait, Here’s What You Can Do Right Now
Until then, we can make some general recommendations about exercise to help protect men’s (and women’s) brains. Assuming you have had a cardiovascular screening for safety and have been cleared by your doctor, you should try to exercise at least three times a week for 30 to 40 minutes each session. You want to aim for a moderate- to high-intensity workout, hitting 60 to 80 percent of your age-determined maximum rate. In other words, you should be able to answer a simple question while performing mid-moderate- to high-intensity exercise, but not be able to have a full-on conversation about last night’s game or debate the Kant vs. Aristotle approach to ethics. If you’re feeling chatty on the Peloton Bike or Peloton Tread, you are probably not working hard enough. And sadly, gentler exercise may not have the same protective effects.
Scientists do not currently know enough to recommend a specific type of workout, but we do know that aerobic activity offers more benefits than strength training. So, choose something that gets your heart pumping, whether it is on the Peloton Bike, Peloton Tread, mat or outdoors.
Jay Alberts, PhD is a Cleveland Clinic scientist and paid consultant of the Peloton Health and Wellness Advisory Council. His research is aimed at understanding the structure-function relationships within the central nervous system and evaluating the impact of behavioral and surgical interventions to improve motor and non-motor function in Parkinson’s disease, stroke, Alzheimer’s and other neurological populations. Dr. Alberts is currently leading two multi-site clinical trials investigating the role of exercise in slowing the progression of Parkinson’s disease.
This content is for informational and educational purposes only and does not constitute individualized advice. It is not intended to replace professional medical evaluation, diagnosis, or treatment. Seek the advice of your physician for questions you may have regarding your health or a medical condition. If you are having a medical emergency, call your physician or 911 immediately.