Cited by 1,214Physical Activity and HealthDementia and Cognitive Impairment ResearchCardiovascular and exercise physiology

The DOI matches its Crossref record; 90 of the 90 references it cites were found in a registry or an index; none of the 73 sources its claims cite is checked for support yet.

Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines

Open access

Abstract

Purpose: Physical activity (PA) is known to improve cognitive and brain function, but debate continues regarding the consistency and magnitude of its effects, populations and cognitive domains most affected, and parameters necessary to achieve the greatest improvements (e.g., dose). Methods: In this umbrella review conducted in part for the 2018 Health and Human Services Physical Activity Guidelines for Americans Advisory Committee, we examined whether PA interventions enhance cognitive and brain outcomes across the life span, as well as in populations experiencing cognitive dysfunction (e.g., schizophrenia). Systematic reviews, meta-analyses, and pooled analyses were used. We further examined whether engaging in greater amounts of PA is associated with a reduced risk of developing cognitive impairment and dementia in late adulthood. Results: Moderate evidence from randomized controlled trials indicates an association between moderate- to vigorous-intensity PA and improvements in cognition, including performance on academic achievement and neuropsychological tests, such as those measuring processing speed, memory, and executive function. Strong evidence demonstrates that acute bouts of moderate- to vigorous-intensity PA have transient benefits for cognition during the postrecovery period after exercise. Strong evidence demonstrates that greater amounts of PA are associated with a reduced risk of developing cognitive impairment, including Alzheimer’s disease. The strength of the findings varies across the life span and in individuals with medical conditions influencing cognition. Conclusions: There is moderate-to-strong support that PA benefits cognitive functioning during early and late periods of the life span and in certain populations characterized by cognitive deficits.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This umbrella review for the 2018 Physical Activity Guidelines Advisory Committee concludes there is moderate-to-strong evidence that physical activity benefits cognition and brain outcomes across parts of the lifespan and in some clinical populations. Evidence is strongest for acute cognitive benefits, reduced risk of cognitive impairment/dementia with greater physical activity, and effects in preadolescent children and older adults.

Key findings

  • Moderate evidence from randomized controlled trials indicates moderate-to-vigorous physical activity improves cognition, including academic achievement and neuropsychological tests of processing speed, memory, and executive function.
  • Strong evidence shows acute bouts of moderate-to-vigorous physical activity produce transient post-exercise cognitive benefits; acute executive-function effects were larger in preadolescent children (Hedges’ g = 0.54 [0.21, 0.87]) and older adults (0.67 [0.40, 0.93]) than adolescents (0.04 [−0.14, 0.23]) and young adults (0.20 [0.07, 0.34]).
  • Strong evidence from prospective observational studies links greater physical activity to reduced risk of cognitive impairment and Alzheimer’s disease: one meta-analysis of 15 prospective studies with >33,000 participants found a 38% reduced risk of cognitive decline, and another of 10 prospective studies with >20,000 participants found a 40% reduced risk of developing Alzheimer’s disease.
  • Evidence grades varied by population: Moderate for children 6–13 years and older adults >50 years; Limited for adolescents; Not Assignable for children ≤6 years and young/middle-aged adults 18–50 years; Moderate for several clinical populations; and insufficient/Not Assignable for optimal dose parameters.

Methods

  • Umbrella review conducted in part for the 2018 Health and Human Services Physical Activity Guidelines for Americans Advisory Committee, using systematic reviews, meta-analyses, and pooled analyses.
  • Searches in PubMed, CINAHL, and Cochrane included English-language systematic reviews, meta-analyses, or pooled analyses published 2003 to February 2017, with an updated search adding 44 studies from 2017–2018; 76 articles were identified (35 meta-analyses; 41 systematic reviews).
  • Evidence was graded as Not Assignable, Limited, Moderate, or Strong; studies of non-ambulatory people, hospitalized patients, or animals were excluded, and the protocol was registered at PROSPERO #CRD42018095774.

Limitations

  • The paper states significant heterogeneity in study designs, cognitive instruments, lack of consistent reporting of blinding and adherence/compliance, poor descriptions of whether interventions maintained moderate-intensity physical activity, and variability in physical activity measurement.
  • The paper states insufficient data on optimal dose parameters, few high-quality data in adolescents and young/middle-aged adults, and that many executive-function instruments were developed for clinical diagnosis rather than detecting normative variation.
  • The paper states that MCI/dementia risk evidence comes largely from prospective observational studies often using self-reported physical activity, unlike RCT-based sections; it also notes small/underpowered studies and inability to assess clinical significance in some dementia-prevention evidence. An evident limitation is that this is an umbrella review of reviews rather than a new primary-data synthesis.

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Integrity signals

Registry

Crossref · 10.1249/mss.0000000000001936

Cites

90 of 90 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

52 Not checked yet · 34 No basis given · 12 Own interpretation · 3 Own method · 2 Own result

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Show all 57 claims

  • It may state two separate claims as one. 36
  • Probably not a substantial claim. 12
46 of 46
  • The paper relies on this without support.

    Many executive function instruments are traditional neuropsychological tools designed for clinical diagnosis rather than for measuring normative individual differences.

    “many of the instruments used to assess executive functioning are traditional neuropsychological tools that were primarily developed to aid in clinical diagnosis rather than to assess individual variation in normative cognitive functioning.”
  • The paper relies on this without support.

    Self-reported physical activity measures used in prospective observational studies are valid indicators of actual physical activity.

    “the studies were prospective and observational and typically used self-reported measures of PA”
  • The paper relies on this without support.

    The positive effects observed in the reviewed literature are not primarily due to publication bias or selective reporting.

    “Yet, despite these limitations and heterogeneity, we argue that the consistency of effects and of effect sizes across populations (16, 26), durations of PA (including acute bouts), intensities, comorbid conditions (58), and ages (12) is truly remarkable”
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Metadata

Authors
ERICKSON, K. I., HILLMAN, C., STILLMAN, C. M., BALLARD, R. M., BLOODGOOD, B., CONROY, D. E., MACKO, R., MARQUEZ, D. X., PETRUZZELLO, S. J., & POWELL, K. E.
Affiliations
  • University of Pittsburgh (US)
  • Northeastern University (US)
  • National Institutes of Health (US)
  • ICF International (United States) (US)
  • Pennsylvania State University (US)
  • University of Maryland, Baltimore (US)
  • Department of Kinesiology and Nutrition, Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL;
  • University of Illinois Urbana-Champaign (US)
  • Centers for Disease Control and Prevention (US)
Venue
Medicine & Science in Sports & Exercise
Published
2019-06
Volume
51
Issue
6
Pages
1242-1251
ISSN
  • 0195-9131 (ISSN-L)
  • 1530-0315
OpenAlex
W2945893642
Cited by
1,214
References
89
Citations by year
2026: 184 · 2025: 216 · 2024: 217 · 2023: 201 · 2022: 176 · 2021: 131 · 2020: 73 · 2019: 12
FWCI
11.51
Type
journal article
Language
en
Open access
Locations
  • Medicine & Science in Sports & Exercise (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (Z99 OD999999)
  • National Institute on Aging (P30AG024827, P30AG028747)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
Keywords
physical activity, cognitive function, brain function, moderate-to-vigorous intensity exercise, acute exercise effects, processing speed, memory, executive function, academic performance, cognitive impairment, dementia risk, Alzheimer's disease, schizophrenia, lifespan, exercise dose
MeSH terms
Aging, Brain, Cognition, Cognition Disorders, Humans, Physical Fitness, Exercise, Practice Guidelines as Topic, Risk Reduction Behavior

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