Skip to main content Accessibility help

Aerobic Exercise Improves Mood, Cognition, and Language Function in Parkinson’s Disease: Results of a Controlled Study

  • Lori J.P. Altmann (a1) (a2), Elizabeth Stegemöller (a1) (a3), Audrey A. Hazamy (a4), Jonathan P. Wilson (a5), Dawn Bowers (a1) (a6), Michael S. Okun (a1) (a7) and Chris J. Hass (a1) (a8)...


Objectives: Parkinson’s disease (PD) results in a range of non-motor deficits that can affect mood, cognition, and language, and many of these issues are unresponsive to pharmacological intervention. Aerobic exercise can improve mood and cognition in healthy older adults, although only a few studies have examined exercise effects on these domains in PD. The current study assesses the effects of aerobic exercise on aspects of cognition, mood, and language production in people with PD. Methods: This study compares the effects of aerobic exercise to stretch-balance training and a no-contact control group in participants with idiopathic PD. The aerobic and stretch-balance groups trained three times a week for 16 weeks, while controls continued normal activities. Outcome measures included disease severity, mood, cognition (speed of processing, memory, and executive function), and language production (picture descriptions). Cognition and language were assessed in single and dual task conditions. Results: Depressive symptoms increased only in the control group (p<.02). Executive function improved in the aerobic exercise group only in the single task (p=.007) and declined in controls in the dual task. Completeness of picture descriptions improved significantly more in the aerobic group than in the stretch-balance group (p<.02). Conclusions: Aerobic exercise is a viable intervention for PD that can be protective against increased depressive symptoms, and can improve several non-motor domains, including executive dysfunction and related aspects of language production. (JINS, 2016, 22, 878–889)


Corresponding author

Correspondence and reprint requests to: Lori J. P. Altmann, Box 100174, 1220 Center Drive, University of Florida, Gainesville, FL 32610-0174. E-mail:


Hide All
Aarsland, D., Andersen, K., Larsen, J.P., Lolk, A., & Kragh-Sorensen, P. (2003). Prevalence and characteristics of dementia in Parkinson disease: An 8-year prospective study. Archives of Neurology, 60(3), 387392.
Altmann, L.J.P., Stegemöller, E., Hazamy, A.A., Wilson, J.P., Okun, M.S., McFarland, N.R., & Hass, C.J. (2015). Unexpected dual task benefits on cycling in Parkinson disease and healthy adults: A neuro-behavioral model. PLoS One, 13, e0125470. doi:10.1371/journal.pone.0125470
Altmann, L.J.P., & Troche, M.S. (2011). High-level language production in Parkinson’s disease: A review. Parkinon’s Disease, 2011, 238956. doi:10.4061/2011/238956
American Parkinson’s Disease Association. (2009). Be active. Retrieved from
Anderson-Hanley, C., Arciero, P.J., Brickman, A.M., Nimon, J.P., Okuma, N., Westen, S.C., & Zimmerman, E.A. (2012). Exergaming and older adult cognition: A cluster randomized clinical trial. American Journal of Preventive Medicine, 42(2), 109119. doi:
Barone, P., Antonini, A., Colosimo, C., Marconi, R., Morgante, L., Avarello, T.P., & Ceravolo, R. (2009). The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson’s disease. Movement Disorders, 24(11), 16411649. doi:10.1002/mds.22643
Bastiaanse, R., & Leenders, K.L. (2009). Language and Parkinson’s disease. Cortex, 45, 912914.
Bayles, K.A. (1990). Language and Parkinson disease. Alzheimer Disease and Associated Disorders, 4(3), 171180.
Beck, A.T., & Steer, R.A. (1993). Beck Anxiety Inventory Manual. San Antonio, TX: Harcourt Brace and Company.
Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.
Bland, W., Busam, V., Gunlogson, B., Mekkes, G., & Saunders, A. (2006). Audacity: A free digital audio editor (Version 1.2.6). Retrieved from
Blumenthal, J.A., Babyak, M.A., Moore, K.A., et al. (1999). Effects of exercise training on older patients with major depression. Archives of Internal Medicine, 159(19), 23492356. doi:10.1001/archinte.159.19.2349
Bock, K., Loebell, H., & Morey, R. (1992). From conceptual roles to structural relations: Bridging the syntactic cleft. Psychological Review, 99(1), 150171. doi:10.1037/0033-295X.99.1.150
Bopp, K.L., & Verhaeghen, P. (2005). Aging and verbal memory span: A meta-analysis. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 60B(5), P223P233.
Buysse, D.J., Reynolds, C.F., Monk, T.H., Berman, S.R., & Kupfer, D.J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193213.
Coelho, F.G., Andrade, L.P., Pedroso, R.V., Santos-Galduroz, R.F., Gobbi, S., Costa, J.L., & Gobbi, L.T. (2013). Multimodal exercise intervention improves frontal cognitive functions and gait in Alzheimer’s disease: A controlled trial. Geriatrics & Gerontology International, 13(1), 198203. doi:10.1111/j.1447-0594.2012.00887.x
Colcombe, S.J., Erickson, K.I., Scalf, P.E., Kim, J.S., Prakash, R., McAuley, E., & Kramer, A.F. (2006). Aerobic exercise training increases brain volume in aging humans. The Journal so Gerontology. Series A, Biological Sciences and Medical Sciences, 61(11), 11661170.
Colman, K.S.F., Koerts, J., van Beilen, M., Leenders, K.L., Post, W.J., & Bastiaanse, R. (2009). The impact of executive functions on verb production in patients with Parkinson’s disease. [Research Support, Non-U.S. Gov’t]. Cortex, 45(8), 930942. doi:10.1016/j.cortex.2008.12.010
Conway, A.R.A., Kane, M.J., Bunting, M.F., Hambrick, D.Z., Wilhelm, O., & Engle, R.W. (2005). Working memory span tasks: A methodological review and user’s guide. [Review]. Psychonomic Bulletin & Review, 12(5), 769786.
Cooper, J.A., Sagar, H.J., Jordan, N., Harvey, N.S., & Sullivan, E.V. (1991). Cognitive impairment in early, untreated Parkinson’s disease and its relationship to motor disability. Brain, 114(5), 20952122.
Cotman, C.W., & Berchtold, N.C. (2002). Exercise: A behavioral intervention to enhance brain health and plasticity. Trends in Neurosciences, 25(6), 295301.
Cruise, K.E., Bucks, R.S., Loftus, A.M., Newton, R.U., Pegoraro, R., & Thomas, M.G. (2010). Exercise and Parkinson’s: Benefits for cognition and quality of life. Acta Neurologica Scandinavica, 123, 1319. doi:10.1111/j.1600-0404.2010.01338.x
Cummings, J.L., Darkins, A., Mendez, M., & Hill, M.A. (1988). Alzheimer’s disease and Parkinson’s disease: Comparison of speech and language alterations. Neurology, 38(5), 680684.
David, F.J., Robichaud, J.A., Leurgans, S.E., Poon, C., Kohrt, W.M., Goldman, J.G., & Corcos, D.M. (2015). Exercise improves cognition in Parkinson’s disease: The PRET‐PD randomized, clinical trial. Movement Disorders, 30, 16571663. doi:10.1002/mds.262
Dishman, R.K., Berthoud, H.R., Booth, F.W., Cotman, C.W., Edgerton, V.R., Fleshner, M.R., & Zigmond, M.J. (2006). Neurobiology of exercise. Obesity (Silver Spring, Md), 14(3), 345356. doi:10.1038/oby.2006.46
Emre, M. (2003). What causes mental dysfunction in Parkinson’s disease? Movement Disorders, 18(S6), 6371.
Erickson, K.I., Voss, M.W., Prakash, R.S., Basak, C., Szabo, A., Chaddock, L., & Kramer, A.F. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences of the United States of America, 108(7), 30173022. doi:10.1073/pnas.1015950108
Eriksen, B.A., & Eriksen, C.W. (1974). Effects of noise letters upon the identification of a target letter in a nonsearch task. Perception & Psychophysics, 16(1), 143149.
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189198. doi:10.1016/0022-3956(75)90026-6
Fougnie, D., & Marois, R. (2006). Distinct capacity limits for attention and working memory: Evidence from attentive tracking and visual working memory paradigms. Psychological Science, 17(6), 526534. doi:10.1111/j.1467-9280.2006.01739.x
Fournet, N., Moreaud, O., Roulin, J.L., Naegele, B., & Pellat, J. (2000). Working memory functioning in medicated Parkinson’s disease patients and the effect of withdrawal of dopaminergic medication. [Comparative Study]. Neuropsychology, 14(2), 247253.
Godin, G., & Shephard, R. (1997). Godin leisure-time exercise questionnaire. Medicine and Science in Sports and Exercise, 29(6), 3638.
Goetz, C.G., Fahn, S., Martinez-Martin, P., Poewe, W., Sampaio, C., Stebbins, G.T., & LaPelle, N. (2007). Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan. Movement Disorders, 22(1), 4147. doi:10.1002/mds.21198
Harrison, D.J., Busse, M., Openshaw, R., Rosser, A.E., Dunnett, S.B., & Brooks, S.P. (2013). Exercise attenuates neuropathology and has greater benefit on cognitive than motor deficits in the R6/1 Huntington’s disease mouse model. Experimental Neurology, 248, 457469.
Hoehn, M., & Yahr, M.D. (1967). Parkinsonisam: Onset, progression and mortality. Neurology, 17, 427442.
Jarvis, B. (2006a). DirectRT. New York: Empirisoft.
Jarvis, B. (2006b). MediaLab. New York: Empirisoft.
Jones, J.D., Butterfield, L.C., Song, W., Lafo, J., Mangal, P., Okun, M.S., & Bowers, D. (2015). Anxiety and depression are better correlates of Parkinson’s disease quality of life than apathy. The Journal of Neuropsychiatry and Clinical Neurosciences, 27(3), 213218. doi:10.1176/appi.neuropsych.13120380
Jones, J.D., Malaty, I., Price, C.C., Okun, M.S., & Bowers, D. (2012). Health comorbidities and cognition in 1948 patients with idiopathic Parkinson’s disease. Parkinsonism & Related Disorders, 18(10), 10731078. doi:10.1016/j.parkreldis.2012.06.004
Jones, J.D., Marsiske, M., Okun, M.S., Bowers, D., Jones, J.D., Butterfield, L.C., & Bowers, D. (2015). Latent growth-curve analysis reveals that worsening Parkinson’s disease quality of life is driven by depression. Neuropsychology, 29(4), 603609. doi:10.1037/neu0000158
Kahneman, D. (1970). Remarks on attentional control. In A.F. Sanders (Ed.), Attention and performance III (pp. 118131). Amsterdam: North Holland Publishing Co.
Kempler, D. (2003). Kempler Sentence Comprehension Task. Boston: Emerson College.
Leentjens, A.F.G. (2004). Depression in Parkinson’s disease: Conceptual issues and clinical challenges. [Review]. Journal of Geriatric Psychiatry and Neurology, 17(3), 120126. doi:10.1177/0891988704267456
Lezak, M.D., Howieson, D.B., Loring, D.W., Hannay, H.J., & Fischer, J.S. (2004). Neuropsychological assessment ((4th ed.), New York, NY: Oxford University Press.
Little, T.D., Rhemtulla, M., Gibson, K., & Schoemann, A.M. (2013). Why the items versus parcels controversy needn’t be one. Psychological Methods, 18(3), 285.
Marin, R.S., Biedrzycki, R.C., & Firinciogullari, S. (1991). Reliability and validity of the Apathy Evaluation Scale. Psychiatry Research, 38(2), 143162.
Martinez‐Martin, P., Rodriguez‐Blazquez, C., Kurtis, M.M., & Chaudhuri, K. (2011). The impact of non‐motor symptoms on health‐related quality of life of patients with Parkinson’s disease. [Multicenter Study]. Movement Disorders, 26(3), 399406. doi:10.1002/mds.23462
Mattis, S. (1988). Dementia Rating Scale: Professional manual. Odessa, FL: Psychological Assessment Resources.
Murray, L.L. (2000). Spoken language production in Huntington’s and Parkinson’s diseases. Journal of Speech, Language, and Hearing Research, 43(6), 13501366. doi:10.1044/jslhr.4306.1350
Murray, L.L. (2008). Language and Parkinson’s disease. Annual Review of Applied Linguistics, 28, 113127. doi:10.1017/S0267190508080100
Nocera, J.R., Altmann, L.J.P., Sapienza, C., Okun, M.S., & Hass, C.J. (2010). Can exercise improve language and cognition in Parkinson’s disease? A case report. Neurocase, 16(4), 301306.
Nystrom, L.E., Braver, T.S., Sabb, F.W., Delgado, M.R., Noll, D.C., & Cohen, J.D. (2000). Working memory for letters, shapes, and locations: fMRI evidence against stimulus-based regional organization in human prefrontal cortex. Neuroimage, 11(5 Pt 1), 424446.
Owen, A.M., Iddon, J.L., Hodges, J.R., & Summers, B.A. (1997). Spatial and non-spatial working memory at different stages of Parkinson’s disease. Neuropsychologia, 35(4), 519532. doi:10.1016/S0028-3932(96)00101-7
Parkinsons Disease Foundation. (2016). Statistics on Parkinson’s. Retrieved from Accessed May 3, 2016.
Pirozzolo, F.J., Hansch, E.C., Mortimer, J.A., Webster, D.D., & Kuskowski, M.A. (1982). Dementia in Parkinson’s disease: A neuropsychological analysis. Brain and Cognition, 1, 7183.
Saint-Cyr, J.A., Trepanier, L.L., Kumar, R., Lozano, A.M., & Lang, A.E. (2000). Neuropsychological consequences of chronic bilateral stimulation of the subthalamic nucleus in Parkinson’s disease. Brain, 123(Pt 10), 20912108.
Skeel, R.L., Crosson, B., Nadeau, S.E., Algina, J., Bauer, R.M., & Fennell, E.B. (2001). Basal ganglia dysfunction, working memory, and sentence comprehension in patients with Parkinson’s disease. Neuropsychologia, 39(9), 962971.
Slaughter, J.R., Slaughter, K.A., Nichols, D., Holmes, S.E., & Martens, M.P. (2001). Prevalence, clinical manifestations, etiology, and treatment of depression in Parkinson’s disease. [Review]. The Journal of Neuropsychiatry and Clinical Neurosciences, 13(2), 187196. doi:10.1176/jnp.13.2.187
Suzuki, T., Shimada, H., Makizako, H., Doi, T., Yoshida, D., Ito, K., & Kato, T. (2013). A randomized controlled trial of multicomponent exercise in older adults with mild cognitive impairment. PLoS One, 8(4), e61483.
Tanaka, K., de Quadros, A.C. Jr., Santos, R.F., Stella, F., Gobbi, L.T.B., & Gobbi, S. (2009). Benefits of physical exercise on executive functions in older people with Parkinson’s Disease. Brain and Cognition, 69(2), 435441. doi:10.1016/j.bandc.2008.09.008
Taylor, A.E., Saint-Cyr, J.A., & Lang, A.E. (1986). Frontal lobe dysfunction in Parkinson’s disease. The cortical focus of neostriatal outflow. Brain, 109(5), 845883.
Troche, M.S., & Altmann, L.J.P. (2012). Sentence production in Parkinson’s disease: Effects of conceptual and task complexity. Applied Psycholinguistics, 33, 225251. doi:10.1017/S0142716411000336
Uc, E.Y., Doerschug, K.C., Magnotta, V., Dawson, J.D., Thomsen, T.R., Kline, J.N., & Grabowski, T.J. (2014). Phase I/II randomized trial of aerobic exercise in Parkinson disease in a community setting. Neurology, 83(5), 413425.
Voss, M.W., Prakash, R.S., Erickson, K.I., Basak, C., Chaddock, L., Kim, J.S., & Kramer, A.F. (2010). Plasticity of brain networks in a randomized intervention trial of exercise training in older adults. Frontiers in Aging Neuroscience, 2, pii: 32 doi:10.3389/fnagi.2010.00032
Wechsler, D. (1997). Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). San Antonio, TX: The Psychological Corporation.
Weerkamp, N.J., Tissingh, G., Poels, P.J., Zuidema, S.U., Munneke, M., Koopmans, R.T., & Bloem, B.R. (2013). Nonmotor symptoms in nursing home residents with Parkinson’s disease: Prevalence and effect on quality of life. Journal of the American Geriatrics Society, 61(10), 17141721.


Related content

Powered by UNSILO
Type Description Title
Supplementary materials

Altmann supplementary material
Tables S1-S3

 Word (24 KB)
24 KB

Aerobic Exercise Improves Mood, Cognition, and Language Function in Parkinson’s Disease: Results of a Controlled Study

  • Lori J.P. Altmann (a1) (a2), Elizabeth Stegemöller (a1) (a3), Audrey A. Hazamy (a4), Jonathan P. Wilson (a5), Dawn Bowers (a1) (a6), Michael S. Okun (a1) (a7) and Chris J. Hass (a1) (a8)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.