Physical activity and risk of cognitive decline: a meta-analysis of prospective studies
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Abstract. Sofi F, Valecchi D, Bacci D, Abbate R, Gensini GF, Casini A, Macchi C (Centro S. Maria agli Ulivi, Onlus IRCCS; Thrombosis Centre, University of Florence; Azienda Ospedaliero-Universitaria Careggi, Florence, Italy) Physical activity and risk of cognitive decline: a meta-analysis of prospective studies. J Intern Med 2011; 269: 107–117. Objective. The relationship between physical activity and cognitive function is intriguing but controversial. We performed a systematic meta-analysis of all the available prospective studies that investigated the association between physical activity and risk of cognitive decline in nondemented subjects. Methods. We conducted an electronic literature search through MedLine, Embase, Google Scholar, Web of Science, The Cochrane Library and bibliographies of retrieved articles up to January 2010. Studies were included if they analysed prospectively the association between physical activity and cognitive decline in nondemented subjects. Results. After the review process, 15 prospective studies (12 cohorts) were included in the final analysis. These studies included 33 816 nondemented subjects followed for 1–12 years. A total of 3210 patients showed cognitive decline during the follow-up. The cumulative analysis for all the studies under a random-effects model showed that subjects who performed a high level of physical activity were significantly protected (−38%) against cognitive decline during the follow-up (hazard ratio (HR) 0.62, 95% confidence interval (CI) 0.54–0.70; P < 0.00001). Furthermore, even analysis of low-to-moderate level exercise also showed a significant protection (−35%) against cognitive impairment (HR 0.65, 95% CI 0.57–0.75; P < 0.00001). Conclusion. This is the first meta-analysis to evaluate the role of physical activity on cognitive decline amongst nondemented subjects. The present results suggest a significant and consistent protection for all levels of physical activity against the occurrence of cognitive decline.
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Numerous randomized controlled trials and meta-analyses have demonstrated positive effects of physical activity on global cognition in older adults.
“Numerous randomized controlled trials (RCTs) and meta-analyses have demonstrated the positive effects of physical activity on global cognition in older adults (Sofi et al., 2011).”
From Optimal exercise interventions for enhancing cognitive function in older adults: a network meta-analysis (2025) · cites this paper as Sofi et al., 2011
The Meta-analysis section (page not given) reports that physical activity was associated with a lower risk of cognitive decline, and the study-selection section says most included studies assessed cognition with the MMSE. But the paper pooled prospective studies, not randomized controlled trials; its findings do not establish the trial-demonstrated effects claimed in the citing sentence. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThere is Strong evidence that greater amounts of physical activity are associated with reduced risk of cognitive decline and dementia, including Alzheimer's disease.
“There is Strong evidence indicating that greater amounts of PA is associated with a reduced risk of cognitive decline (51) and dementia, including AD (42).”
From Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines (2019) · cites this paper as [51]
A meta-analysis of 15 prospective studies lasting 1 to 12 years with more than 33,000 participants found that greater physical activity was associated with a 38% reduced risk of cognitive decline.
“For example, a meta-analysis of 15 prospective studies ranging from 1-12 years in duration with more than 33,000 participants found that greater amounts of PA were associated with a 38% reduced risk of cognitive decline (51).”
From Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines (2019) · cites this paper as [51]
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- Authors
- Sofi, F., Valecchi, D., Bacci, D., Abbate, R., Gensini, G. F., Casini, A., & Macchi, C.
- Affiliations
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Don Carlo Gnocchi Foundation (IT)
- University of Florence (IT)
- Corresponding author
- Sofi, F.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 2010-09-10
- Volume
- 269
- Issue
- 1
- Pages
- 107-117
- ISSN
- 0954-6820 (ISSN-L)
- OpenAlex
- W1766928376
- Cited by
- 1,210
- References
- 23
- Citations by year
- 2026: 47 · 2025: 89 · 2024: 89 · 2023: 78 · 2022: 101 · 2021: 105 · 2020: 103 · 2019: 98 · 2018: 100 · 2017: 85 · 2016: 75 · 2015: 84 · 2014: 51 · 2013: 49 · 2012: 33
- FWCI
- 4.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- physical activity, cognitive decline, cognitive impairment, dementia prevention, cognitive function
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cognition Disorders, Dementia, Female, Humans, Male, Middle Aged, Motor Activity, Prospective Studies, Sensitivity and Specificity, Exercise, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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