Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging
Open accessAbstract
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]).”
From Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety (2018) · cites this paper as [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).”
From Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment (2016) · cites this paper as Ahlskog et al., 2011
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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)
- PMC
- PMC3258000
- 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
- bronze
- doi.org
- 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
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.
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