Association of physical activity with the risk of Parkinson's disease in depressive disorder: A nationwide longitudinal cohort study

Regular physical activity (PA) has been suggested as effective disease preventable strategies for Parkinson's disease (PD). Depression often precedes PD but whether PA also would reduce the risk of PD in patients with depression has not been known. The aim of study is to examine the association of regular PA with risk of PD among patients with depressive disorder. A total of 1,342,282 patients with depressive disorder were identified from a nationwide health screening cohort from 2010 to 2016. The exposure was changes in pattern of regular PA between pre-and post-diagnosis of depressive disorder, categorized as four groups; 1) no PA, 2) increased PA, 3) decreased PA, and 4) maintaining PA. The outcome was risk of incident PD, calculated using multivariate adjusted Cox proportional hazards regressions according to the PA categorization. Total of 8901 PD cases (0.66%) were developed during 5.3 years of follow-up period. Maintaining PA group was associated with the lowest risk of PD (adjusted hazard ratio [aHR] 0.89, 95% CI 0.83-0.97) among all other PA groups with depressive disorder (with no PA group as reference). Otherwise, decreased PA group significantly increased the risk of PD (aHR 1.10, 95% CI 1.03-1.16). Those who maintained PA before and after diagnosis of depressive disorder were associated with lower risk of incident PD.