Exercise for Older Adults Improves the Quality of Life in Parkinson’s Disease and Potentially Enhances the Immune Response to COVID-19

Abstract

Parkinson’s disease (PD) is a progressive neurodegenerative disorder brought about due to dopaminergic neuronal cell loss in the midbrain substantia nigra pars compacta region. PD presents most commonly in older adults and is a disorder of both motor and nonmotor dysfunction. The novel SARS-CoV-2 virus is responsible for the recent COVID-19 pandemic, and older individuals, those with preexisting medical conditions, or both have an increased risk of developing COVID-19 with more severe outcomes. People-with-Parkinson’s (PwP) of advanced age can have both immune and autonomic nervous problems that potentially lead to pre-existing pulmonary dysfunction and higher infection risk, increasing the probability of contracting COVID-19. A lifestyle change involving moderate-intensity exercise has the potential to protect against SARS-CoV-2 through strengthening the immune system. In addition to a potential protective measure against SARS-CoV-2, exercise has been shown to improve quality-of-life (QoL) in PD patients. Recent studies provide evidence of exercise as both neuroprotective and neuroplastic. This article is a literature review investigating the role exercise plays in modifying the immune system, improving health outcomes in PwP, and potentially acting as a protective measure against SARS-Cov-2 infection. We conclude that exercise, when correctly performed, improves QoL and outcomes in PwP, and that the enhanced immune response from moderate-intensity exercise could potentially offer additional protection against COVID-19.

Impactos globais da infecção por COVID-19 em pacientes com a doença de Parkinson: uma revisão integrativa

“…A DP é caracterizada pela degeneração progressiva dos neurônios dopaminérgicos da substância negra parte compacta (SNpc) que se projetam para o corpo estriado, que por sua vez está relacionada com o acúmulo da proteína alfa-sinucleína, que se agregam formando corpos de Lewy nas células causando disfunção e morte celular (Hall & Church, 2020;Schirinzi, Landi, et al, 2020). Devido ao comprometimento da SNpc, os portadores da DP apresentam sintomas motores como: tremor de repouso, movimentos lentos, rigidez e instabilidade postural, entretanto, além disso sintomas não motores como: depressão, psicose, desordens do sono e demência também estão presentes em indivíduos acometidos por esta neuropatologia (Hall & Church, 2020). (Sulzer et al, 2020).…”

Covid-19 impact on Parkinson’s Disease patients treated by drugs or deep brain stimulation

“…A lower prevalence of Covid-19 in PD patients was not expected as it has been hypothesized in many articles that PD patients are at higher risk for being infected with SARS-CoV-19 due to some reasons as below. Pathophysiological processes of PD lead to respiratory complications [14], gastrointestinal problems [15], sedentary lifestyle [4, 16], immune systems malfunction [16], nervous systems dysfunction [4, 16], and a need for using medications with possible side effects and drug interactions [17], may place PD patients at higher risks of mortality and morbidity subsequent to Covid-19 infection. However, the effect of anti-PD drugs was found to be insignificant on the prevalence of Covid-19 [17].…”

“…Pathophysiological processes of PD lead to respiratory complications [14], gastrointestinal problems [15], sedentary lifestyle [4, 16], immune systems malfunction [16], nervous systems dysfunction [4, 16], and a need for using medications with possible side effects and drug interactions [17], may place PD patients at higher risks of mortality and morbidity subsequent to Covid-19 infection. However, the effect of anti-PD drugs was found to be insignificant on the prevalence of Covid-19 [17]. In contrast, in another study, sudden discontinuation of anti-parkinsonian drugs is recognized as a potential cause of death in PD patients infected with Covid-19 [16, 18].…”

“…In this sense, disability in PD patients may increase due to a lack of access to suitable and sufficient medications. This condition may lead to an increase in motor, non-motor, and neuropsychiatric symptoms and possibly higher mortality [17, 18].…”

How COVID-19 will boost remote exercise-based treatment in Parkinson’s disease: a narrative review

“…This is also gaining in relevance during these times as physical exercise reduces the risk of upper respiratory tract viral infections and the associated mortality in a dosedependent manner. Here, moderate intensity exercise (in contrast to high intensity) has the best cell-and cytokine-based effect on the immune system and should be kept in mind when it comes to trainings plans 37 . Summarizing, an overwhelming body of evidence proves that multi-faceted physical therapy might offer preventive and moderating effects on the course of PD, is a vital mainstay of treatment covering all aspects of PD symptoms and might reduce susceptibility to viral infections and associated mortality.…”