Aerobic exercise is more effective than goal-based exercise for the treatment of cognition in Parkinson's disease

Background: Little is known about how different exercise modalities influence cognition in Parkinson's disease (PD). Moreover, the focus of previous investigations on examining the effects of exercise mainly on executive functions and the exclusion of individuals with cognitive impairment may limit the potential to define exercise as a treatment for cognitive decline in PD. Objective: The aim of this study was to compare the effects of aerobic and goal-based exercise on five cognitive domains in cognitively normal and impaired individuals with PD. Methods: Seventy-six individuals with PD were randomly allocated into three groups: Aerobic, Goal-based, and Control. Participants in the exercise groups attended 1-h sessions 3x/week for 12 weeks, while those in the Control group carried on with their regular activities. Changes in cognitive domains were assessed using paper based neuropsychological tests. Results: Inhibitory control improved only in the Aerobic group (p = .04), irrespective of participants cognitive status at baseline. Moreover, participants with cognitive impairment in Aerobic group maintained their set shifting ability, whereas those in the Control group were worse at post-test (p = .014). Conclusion: This is the first study to show that aerobic exercise is more effective than goal-based exercise for the treatment of cognition in PD with and without cognitive impairment.