THE IMPACT OF PHYSICAL ACTIVITY ON DEMENTIA IN ELDERLY AGE
Abstract
Population aging represents one of the greatest public health challenges of the 21st century. As global life expectancy continues to rise, the number of individuals affected by dementia is steadily increasing. Dementia is currently the seventh leading cause of death worldwide and a major contributor to disability and dependence among older adults. It is a clinical syndrome characterized by the progressive decline of cognitive functions such as memory, thinking, comprehension, and planning.
The gradual loss of these abilities profoundly affects individuals’ daily functioning and quality of life, ultimately leading to increasing dependence, reduced autonomy, and social isolation. This imposes a significant burden not only on patients and their families but also on healthcare and social support systems.
In the absence of effective disease-modifying therapies, preventive strategies and the identification of modifiable risk factors have become a primary focus of research and public health policy. Physical inactivity is now widely recognized as one of these modifiable risk factors.
Purpose: The aim of this paper is to present the current state of knowledge regarding the relationship between physical activity and the risk of developing dementia in older age. Other modifiable risk factors for this condition will also be highlighted. The paper will discuss both the biological mechanisms through which physical activity affects cognitive functions and the findings of epidemiological and interventional studies supporting its protective role. Recommendations for physical activity as a component of preventive strategies in aging populations will also be outlined.
Materials and Methods: A comprehensive literature search was performed using the PubMed database, focusing on studies published between 2010 and 2025. Search terms included "dementia", "cognitive disorders", “elderly” and "physical activity". As part of our methodological analysis, we selected 27 publications that met the criteria of evidence-based medicine (EBM). The reviewed literature included studies based on meta-analyses as well as the most recent guidelines issued by leading international scientific societies. Relevant articles were selected and critically assessed to extract and evaluate key findings and conclusions.
Conclusions: Recent evidence from systematic reviews and meta-analyses underscores the critical role of modifiable risk factors in accelerating brain aging and cognitive decline. As life expectancy increases, there is a growing need to prioritize public health education and promote physical activity to prevent dementia and maintain quality of life in aging populations.
References
Bai W, Chen P, Cai H, Zhang Q, Su Z, Cheung T, Jackson T, Sha S, Xiang YT. Worldwide prevalence of mild cognitive impairment among community dwellers aged 50 years and older: a meta-analysis and systematic review of epidemiology studies. Age Ageing. 2022 Aug 2;51(8):afac173. https://doi.org/10.1093/ageing/afac173
Jin S, Lu W, Zhang J, Zhang L, Tao F, Zhang Y, Hu X, Liu Q. The mechanisms, hallmarks, and therapies for brain aging and age-related dementia. Sci Bull (Beijing). 2024 Dec 15;69(23):3756-3776. https://doi.org/10.1016/j.scib.2024.09.005
Livingston G, Huntley J, Liu KY, Costafreda SG, Selbæk G, Alladi S, Ames D, Banerjee S, Burns A, Brayne C, Fox NC, Ferri CP, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Nakasujja N, Rockwood K, Samus Q, Shirai K, Singh-Manoux A, Schneider LS, Walsh S, Yao Y, Sommerlad A, Mukadam N. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024 Aug 10;404(10452):572-628. https://doi.org/10.1016/S0140-6736(24)01296-0
Reparaz-Escudero I, Izquierdo M, Bischoff-Ferrari HA, Martínez-Lage P, Sáez de Asteasu ML. Effect of long-term physical exercise and multidomain interventions on cognitive function and the risk of mild cognitive impairment and dementia in older adults: A systematic review with meta-analysis. Ageing Res Rev. 2024 Sep;100:102463. https://doi.org/10.1016/j.arr.2024.102463
Broadhouse KM, Singh MF, Suo C, Gates N, Wen W, Brodaty H, Jain N, Wilson GC, Meiklejohn J, Singh N, Baune BT, Baker M, Foroughi N, Wang Y, Kochan N, Ashton K, Brown M, Li Z, Mavros Y, Sachdev PS, Valenzuela MJ. Hippocampal plasticity underpins long-term cognitive gains from resistance exercise in MCI. Neuroimage Clin. 2020;25:102182. https://doi.org/10.1016/j.nicl.2020.102182. Epub 2020 Jan 14.
Pöyhönen J, Lehtisalo J, Roitto HM, Levälahti E, Strandberg T, Kivipelto M, Kulmala J, Antikainen R, Soininen H, Tuomilehto J, Laatikainen T, Ngandu T. Impact of frailty status on the effect of a multidomain lifestyle intervention on cognition. Age Ageing. 2025 Feb 2;54(2):afaf041. https://doi.org/10.1093/ageing/afaf041
Ngandu T, Lehtisalo J, Solomon A, Levälahti E, Ahtiluoto S, Antikainen R, Bäckman L, Hänninen T, Jula A, Laatikainen T, Lindström J, Mangialasche F, Paajanen T, Pajala S, Peltonen M, Rauramaa R, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015 Jun 6;385(9984):2255-63. https://doi.org/10.1016/s0140-6736(15)60461-5. Epub 2015 Mar 12.
Kivipelto M, Mangialasche F, Snyder HM, Allegri R, Andrieu S, Arai H, Baker L, Belleville S, Brodaty H, Brucki SM, Calandri I, Caramelli P, Chen C, Chertkow H, Chew E, Choi SH, Chowdhary N, Crivelli L, Torre R, Du Y, Dua T, Espeland M, Feldman HH, Hartmanis M, Hartmann T, Heffernan M, Henry CJ, Hong CH, Håkansson K, Iwatsubo T, Jeong JH, Jimenez-Maggiora G, Koo EH, Launer LJ, Lehtisalo J, Lopera F, Martínez-Lage P, Martins R, Middleton L, Molinuevo JL, Montero-Odasso M, Moon SY, Morales-Pérez K, Nitrini R, Nygaard HB, Park YK, Peltonen M, Qiu C, Quiroz YT, Raman R, Rao N, Ravindranath V, Rosenberg A, Sakurai T, Salinas RM, Scheltens P, Sevlever G, Soininen H, Sosa AL, Suemoto CK, Tainta-Cuezva M, Velilla L, Wang Y, Whitmer R, Xu X, Bain LJ, Solomon A, Ngandu T, Carrillo MC. World-Wide FINGERS Network: A global approach to risk reduction and prevention of dementia.Alzheimers Dement. 2020 Jul;16(7):1078-1094. https://doi.org/10.1002/alz.12123. Epub 2020 Jul 5.
Gale SA, Acar D, Daffner KR. Dementia. Am J Med. 2018 Oct;131(10):1161-1169. https://doi.org/10.1016/j.amjmed.2018.01.022 Epub 2018 Feb 6.
Aarsland, D. (2020). Epidemiology and Pathophysiology of Dementia-Related Psychosis. The Journal of Clinical Psychiatry, 81(5), 27625. https://doi.org/10.4088/jcp.ad19038br1c
Willroth EC, Pfund GN, Rule PD, Hill PL, John A, Kyle K, Hassenstab J, James BD. A Review of the Literature on Wellbeing and Modifiable Dementia Risk Factors. Ageing Res Rev. 2024 Aug;99:102380. https://doi.org/10.1016/j.arr.2024.102380 Epub 2024 Jun 14.
Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446. https://doi.org/10.1016/s0140-6736(20)30367-6 Epub 2020 Jul 30.
Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, Ballard C, Banerjee S, Burns A, Cohen-Mansfield J, Cooper C, Fox N, Gitlin LN, Howard R, Kales HC, Larson EB, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care. Lancet. 2017 Dec 16;390(10113):2673-2734. https://doi.org/10.1016/s0140-6736(17)31363-6 Epub 2017 Jul 20.
Risk Reduction of Cognitive Decline and Dementia: WHO Guidelines. Geneva: World Health Organization; 2019.
Izquierdo M, Merchant RA, Morley JE, Anker SD, Aprahamian I, Arai H, Aubertin-Leheudre M, Bernabei R, Cadore EL, Cesari M, Chen LK, de Souto Barreto P, Duque G, Ferrucci L, Fielding RA, García-Hermoso A, Gutiérrez-Robledo LM, Harridge SDR, Kirk B, Kritchevsky S, Landi F, Lazarus N, Martin FC, Marzetti E, Pahor M, Ramírez-Vélez R, Rodriguez-Mañas L, Rolland Y, Ruiz JG, Theou O, Villareal DT, Waters DL, Won Won C, Woo J, Vellas B, Fiatarone Singh M. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging. 2021;25(7):824-853. https://doi.org/10.1007/s12603-021-1665-8
Yang L, Yuan Z, Peng C. Effects of aerobic exercise on cognitive function and quality of life in patients with Alzheimer’s disease: a systematic review and meta-analysis. BMJ Open. 2025 Jan 11;15(1):e090623. https://doi.org/10.1136/bmjopen-2024-090623
Falck RS, Davis JC, Best JR, Crockett RA, Liu-Ambrose T. Impact of exercise training on physical and cognitive function among older adults: a systematic review and meta-analysis. Neurobiol Aging. 2019 Jul;79:119-130. https://doi.org/10.1016/j.neurobiolaging.2019.03.007 Epub 2019 Mar 26.
Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc. 2011 Sep;86(9):876-84. https://doi.org/10.4065/mcp.2011.0252
Gallardo-Gómez D, Del Pozo-Cruz J, Noetel M, Álvarez-Barbosa F, Alfonso-Rosa RM, Del Pozo Cruz. Optimal dose and type of exercise to improve cognitive function in older adults: A systematic review and bayesian model-based network meta-analysis of RCTs. B. Ageing Res Rev. 2022 Apr;76:101591. https://doi.org/10.1016/j.arr.2022.101591 Epub 2022 Feb 17.
Bliss ES, Wong RH, Howe PR, Mills DE. Benefits of exercise training on cerebrovascular and cognitive function in aging. J Cereb Blood Flow Metab. 2021 Mar;41(3):447-470. https://doi.org/10.1177/0271678x20957807 Epub 2020 Sep 20.
Di Lorito C, Long A, Byrne A, Harwood RH, Gladman JRF, Schneider S, Logan P, Bosco A, van der Wardt V. Exercise interventions for older adults: A systematic review of meta-analyses. J Sport Health Sci. 2021 Jan;10(1):29-47. https://doi.org/10.1016/j.jshs.2020.06.003 Epub 2020 Jun 7.
Eric B. Larson, Li Wang, James D. Bowen, et al. Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older. Ann Intern Med.2006;144:73-81. [Epub 17 January 2006]. https://doi.org/10.7326/0003-4819-144-2-200601170-00004
World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization. https://doi.org/10.1093/eurpub/ckab202.083
Strain T, Flaxman S, Guthold R, Semenova E, Cowan M, Riley LM, Bull FC, Stevens GA, Country Data Author Group. National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5·7 million participants. Lancet Glob Health. 2024 Aug;12(8):e1232-e1243. https://doi.org/10.1016/s2214-109x(24)00150-5 Epub 2024 Jun 25.
Fosstveit E, Haugland SH, Madsen S, Johansen D. The intensity paradox: A systematic review and meta-analysis of its impact on the cardiorespiratory fitness of older adults. Sports Med Health Sci. 2024;6(2):75–85. https://doi.org/10.1111/sms.14573
Gardner MM, Robertson MC, Campbell AJ. Association of long-term exercise training with risk of falls, fractures, hospitalizations, and mortality in older adults: A systematic review and meta-analysis. JAMA Intern Med. 2019;179(3):394–405. https://doi.org/10.1001/jamainternmed.2018.5406
Sert H, Gulbahar Eren M, Gurcay B, Koc F. The effectiveness of high-intensity interval exercise on cardiometabolic health and quality of life in older adults: A systematic review and meta-analysis. BMC Sports Sci Med Rehabil. 2025;17(1):22. https://doi.org/10.1186/s13102-025-01176-5
Views:
40
Downloads:
9
Copyright (c) 2025 Barbara Starosta, Bartosz Brzychcy, Zuzanna Gajda, Monika Pelczar, Karolina Brzychcy, Karolina Paks, Ewa Jench, Natalia Musialik, Maciej Magiera

This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.





