Exercise and ParkinsonÕs: benefits for cognition and quality of life Introduction ParkinsonÕs disease (PD) is classically defined as a disorder of movement. However, a spectrum of cognitive, affective and psychiatric symptoms are now recognized among people with PD (1). Psychosocial well-being is now thought to have more of an impact on the quality of life (QoL) of people with PD than physical functioning (2); with depression identified as the most important pre- dictor of QoL (3). Cognitive impairment has also been identified as an important predictor of QoL among people with PD (4). Subtle cognitive impairment is characteristic of early PD and severe cognitive impairment and dementia fre- quently occur with longer disease durations (1).The most frequently observed neuropsycholog- ical deficit in PD is impaired executive function (EF) (5), which is defined as the ability to plan, organize and regulate goal directed behaviour (6). Current pharmaceutical treatments primarily treat the physical manifestations of PD and have inconsistent effects on cognitive function (7). Depressed mood is a common co-morbid condition among people with PD (5, 8); and anti-depressant medications used to treat depression in PD have been reported to exacerbate the motor symptoms in some instances (8). One intervention that improves both cognitive functioning and psychological well-being is exer- cise. There is evidence of the benefits of regular exercise for neurologically normal older adults (9). Exercise reduces mood disturbances such as depression among both young and older adults (10). Improvements in cognitive functioning as a result of exercise have also been widely demon- strated, with selective benefits for executive func- tioning (EF) (11, 12). Improvements in EF have been associated with increased cardiovascular fitness, with combined cardiovascular and strength training demonstrating the greatest benefits for EF (11). However, the selective benefits of exercise on EF among degenerative conditions such as PD has received limited attention, with only one study to date demonstrating significant benefits of exercise on EF among people with PD (13). Daily activities requiring active problem solving, efficient organi- zation strategies, working memory and regulation of behaviour rely on efficient EF. Improving the cognitive deficits associated with EF may therefore Acta Neurol Scand 2011: 123: 13–19 DOI: 10.1111/j.1600-0404.2010.01338.x Copyright Ó 2010 The Authors Journal compilation Ó 2010 Blackwell Munksgaard ACTA NEUROLOGICA SCANDINAVICA Cruise KE, Bucks RS, Loftus AM, Newton RU, Pegoraro R, Thomas MG. Exercise and ParkinsonÕs: benefits for cognition and quality of life. Acta Neurol Scand: 2011: 123: 13–19. Ó 2010 The Authors Journal compilation Ó 2010 Blackwell Munksgaard. Objectives – The benefits of physical exercise for psychological aspects of quality of life (QoL) are well established in normally ageing adults, yet potential benefits for people with ParkinsonÕs disease (PD) have received limited attention. This study evaluated the benefits of exercise for cognitive functioning, mood and disease-specific QoL for people with PD. Methods – Twenty-eight individuals with PD were allocated to an exercise intervention program (EIP, n= 15) or control group (n = 13). The EIP group undertook a programme of progressive anabolic and aerobic exercise twice weekly for 12 weeks. The control group maintained their usual lifestyle. Results – Exercise was shown to have selective benefits for cognitive functioning by improving frontal lobe based executive function. No significant effects were demonstrated for mood or disease-specific QoL. Conclusions – These results are consistent with previous research demonstrating selective benefits of exercise for executive function among normal ageing adults and PD. K. E. Cruise 1 , R. S. Bucks 1,2 , A. M. Loftus 1,2 , R. U. Newton 1,3 , R. Pegoraro 1 , M. G. Thomas 1,4 1 ParkinsonÕs Centre (ParkC), Vario Health Institute, Edith Cowan University, Joondalup, Perth, WA, Australia; 2 School of Psychology, University of Western Australia, Perth WA, Australia; 3 Vario Health Institute, Edith Cowan University, Joondalup, WA, Australia; 4 Experimental and Regenerative Neuroscience, School of Animal Biology, University of Western Australia, Perth, WA, Australia Key words: cognition; exercise; mood; ParkinsonÕs disease; quality of life Dr Meghan Thomas, ParkinsonÕs Centre (ParkC), Edith Cowan University, Building 21, Level 2, 270 Joondalup Drive, Joondalup, WA 6027, Australia Tel.: +61 8 6488 7515 Fax: +618 6304 2499 e-mail: m.thomas@ecu.edu.au Accepted for publication January 21, 2010 13