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33, 95% confidence interval [CI] -2.12 to -0.47, = 0.002). However, there was a significant interaction between physical activity and ε4 such that higher physical activity was related to slower ε4-related cognitive decline (estimate 0.007, 95% CI 0.003-0.011, = 0.001). No significant interaction was found between physical activity and the ε4 allele regarding the change in striatal DAT activities. Increased physical activity attenuated ε4-related vulnerability to early cognitive decline in patients with PD. This protective effect did no