Cited by 885Dementia and Cognitive Impairment ResearchPhysical Activity and HealthCognitive Functions and Memory

Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging

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Ahlskog, J. Eric, Geda, Yonas E., Graff-Radford, Neill R., Petersen, Ronald C.·2011·Mayo Clinic Proceedings

Abstract

A rapidly growing literature strongly suggests that exercise, specifically aerobic exercise, may attenuate cognitive impairment and reduce dementia risk. We used PubMed (keywords exercise and cognition) and manuscript bibliographies to examine the published evidence of a cognitive neuroprotective effect of exercise. Meta-analyses of prospective studies documented a significantly reduced risk of dementia associated with midlife exercise; similarly, midlife exercise significantly reduced later risks of mild cognitive impairment in several studies. Among patients with dementia or mild cognitive impairment, randomized controlled trials (RCTs) documented better cognitive scores after 6 to 12 months of exercise compared with sedentary controls. Meta-analyses of RCTs of aerobic exercise in healthy adults were also associated with significantly improved cognitive scores. One year of aerobic exercise in a large RCT of seniors was associated with significantly larger hippocampal volumes and better spatial memory; other RCTs in seniors documented attenuation of age-related gray matter volume loss with aerobic exercise. Cross-sectional studies similarly reported significantly larger hippocampal or gray matter volumes among physically fit seniors compared with unfit seniors. Brain cognitive networks studied with functional magnetic resonance imaging display improved connectivity after 6 to 12 months of exercise. Animal studies indicate that exercise facilitates neuroplasticity via a variety of biomechanisms, with improved learning outcomes. Induction of brain neurotrophic factors by exercise has been confirmed in multiple animal studies, with indirect evidence for this process in humans. Besides a brain neuroprotective effect, physical exercise may also attenuate cognitive decline via mitigation of cerebrovascular risk, including the contribution of small vessel disease to dementia. Exercise should not be overlooked as an important therapeutic strategy.

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  • Physical activity-based interventions have demonstrated efficacy in treating symptoms of several mental health conditions ranging from psychosis to dementia.

    “Physical activity (PA)-based interventions represent a novel approach that have demonstrated efficacy in treating symptoms of several mental health conditions ranging from psychosis (e.g. [28, 29])⁠ to dementia (e.g. [30])⁠.”
  • AE is associated with lowering the risk of various other conditions developing, ranging from age- and dementia-related cognitive decline to mood and anxiety disorders.

    “AE is conversely associated with lowering the risk of various other conditions developing that range from age- and dementia-related cognitive decline to mood and anxiety disorders (Martinsen, 2008; Ahlskog et al., 2011; Mammen and Faulkner, 2013).”

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  1. Heyn P, Abreu BC, Ottenbacher KJ. The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Arch Phys Med Rehabil. 2004;85:1694-1704.

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Authors
Ahlskog, J. E., Geda, Y. E., Graff-Radford, N. R., & Petersen, R. C.
Affiliations
Mayo Clinic (US)
Corresponding author
Ahlskog, J. Eric
Venue
Mayo Clinic Proceedings
Publisher
Elsevier BV
Published
2011-09
Volume
86
Issue
9
Pages
876-884
ISSN
0025-6196 (ISSN-L)
OpenAlex
W2139751847
Cited by
885
References
131
Citations by year
2026: 45 · 2025: 48 · 2024: 60 · 2023: 45 · 2022: 90 · 2021: 65 · 2020: 73 · 2019: 62 · 2018: 61 · 2017: 76 · 2016: 59 · 2015: 55 · 2014: 64 · 2013: 47 · 2012: 32
FWCI
6.04
Type
journal article
Language
en
Open access
Locations
  • Mayo Clinic Proceedings (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
Keywords
physical activity, aerobic exercise, dementia, brain aging, mild cognitive impairment, cognitive decline, neuroprotection, hippocampal volume, gray matter loss, neuroplasticity, neurotrophic factors, brain connectivity, cerebrovascular risk, cerebral small vessel disease
MeSH terms
Adult, Aged, Animals, Cognition, Cognition Disorders, Dementia, Health Status, Humans, Memory, Middle Aged, Neuropsychological Tests, Physical Fitness, Exercise, Randomized Controlled Trials as Topic

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