The role of exercise and lifestyle factors in fatigue among Parkinson's disease patients: a cross-sectional study.

BACKGROUND: Parkinson’s disease (PD) is a chronic neurodegenerative disorder characterised by disabling motor and non-motor symptoms; fatigue is among the most common and debilitating. OBJECTIVE: To estimate the prevalence of fatigue in Saudi adults with PD and examine lifestyle and disease-related correlates of fatigue burden. METHODS: We conducted a cross-sectional study of Saudi patients with PD attending the Movement Disorders Clinic at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia, or listed in the Saudi Parkinson’s Society registry. Data were collected anonymously via an electronic, self-administered questionnaire (March–December 2024). Fatigue severity was assessed with the validated Arabic Fatigue Severity Scale (FSS); significant fatigue was defined as FSS ≥ 4. Associations were analyzed with odds ratios (ORs). RESULTS: Among 131 respondents, 61.1% met criteria for significant fatigue. Fatigue was more likely in those reporting muscle pain, orthostatic hypotension, dysphagia, or a history of stroke (all p < 0.05). Lifestyle factors were also relevant: infrequent exercise (≤ 1 time/week) and short daily exercise duration (< 15 min) were associated with higher fatigue likelihood (OR ≈ 2.5, p < 0.05). Lower daily water intake (< 4 cups) independently correlated with fatigue (OR ≈ 2.5, p = 0.02). No significant associations were observed for treatment type, caffeine consumption, or fruit/vegetable intake. CONCLUSIONS: Fatigue is highly prevalent among Saudi patients with PD and relates to both non-motor symptoms (muscle pain, orthostatic hypotension, dysphagia) and modifiable behaviours (physical inactivity and low fluid intake). These findings support routine screening for fatigue and targeted counselling to optimise exercise and hydration, alongside management of non-motor comorbidities.