Randomized trial shows exercise habit correlates with younger brain age in adults — Evidence Review
Published in Journal of Sport and Health Science, by researchers from AdventHealth Research Institute, University of Pittsburgh
Researched by
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Table of Contents
Adults who followed a regular aerobic exercise routine for a year had brains that appeared nearly a year younger on MRI scans, according to a new randomized controlled trial. These findings from the AdventHealth Research Institute build on existing research, which broadly supports exercise as a protective factor for brain health.
- Multiple large meta-analyses and systematic reviews have found that both aerobic and resistance exercise benefit cognitive function and can slow age-related brain changes, aligning with the new study's results 1 3 6 14.
- Prior studies indicate that even modest improvements in brain structure or function with regular physical activity may translate to meaningful reductions in dementia risk or cognitive decline over time, supporting the clinical relevance of the observed changes 1 9 11.
- While the mechanisms remain incompletely understood, related research suggests exercise-induced benefits may involve neuroplasticity, neurotrophic factors, and improved vascular health, though the precise biological pathways still need clarification 2 5 13.
Study Overview and Key Findings
Maintaining brain health as we age is a growing concern, especially as rates of age-related cognitive decline and dementia increase worldwide. This new study is notable for focusing on healthy adults in midlife—an age group where preventive strategies may have the greatest long-term benefit, but which has been less studied compared to older adults. By using advanced MRI techniques to estimate “brain age,” the research provides objective, biological evidence that following recommended exercise guidelines can have a small but measurable impact on the brain, even before overt cognitive impairment appears. The study’s year-long, guideline-based aerobic exercise program reflects realistic lifestyle changes that could be adopted by the general population.
| Property | Value |
|---|---|
| Study Year | 2025 |
| Organization | AdventHealth Research Institute, University of Pittsburgh |
| Journal Name | Journal of Sport and Health Science |
| Authors | Lu Wan, Cristina Molina-Hidalgo, Mary E. Crisafio, George Grove, Regina L. Leckie, Thomas W. Kamarck, Chaeryon Kang, Mia DeCataldo, Anna L. Marsland, Matthew F. Muldoon, Mark R. Scudder, Javier Rasero, Peter J. Gianaros, Kirk I. Erickson |
| Population | Healthy adults aged 26 to 58 |
| Sample Size | n=130 |
| Methods | Randomized Controlled Trial (RCT) |
| Outcome | Brain age, cardiorespiratory fitness |
| Results | Exercise group had brains appear 0.6 years younger on average. |
Literature Review: Related Studies
To contextualize these new findings, we searched the Consensus database of over 200 million research papers using the following queries:
- exercise brain aging effects
- physical activity cognitive function aging
- exercise intervention brain age comparison
Below, we synthesize major themes from the related literature and summarize the evidence on key topics.
| Topic | Key Findings |
|---|---|
| What is the impact of aerobic and resistance exercise on brain aging and cognitive function? | - Aerobic exercise in midlife and later life is associated with reduced risk of dementia, improved cognitive scores, and measurable benefits to brain structure and function 1 3 11 14. - Resistance training also supports improvements in executive function and reduces white matter atrophy, suggesting multiple exercise types can promote healthy brain aging 4 6 14. |
| How do exercise-induced changes in brain structure relate to cognitive outcomes? | - Exercise interventions, especially aerobic training, are linked to increased hippocampal volume, preserved gray matter, and improved connectivity in cognitive brain networks, which may underlie observed cognitive benefits 1 3 5 11. - Some studies suggest the relationship between exercise, brain structure, and cognition is complex, with changes in fitness not always directly explaining brain structural changes 11 12. |
| What mechanisms may mediate the effects of exercise on the aging brain? | - Exercise may benefit the brain by increasing neurotrophic factors (such as BDNF), enhancing neurogenesis, improving vascular health, and modulating inflammatory pathways 1 2 5 13. - Animal and human studies support a role for blood-borne factors and a liver-to-brain axis in mediating some of the regenerative effects of exercise on the aging brain 2 13. |
| What are the optimal exercise prescriptions for cognitive and brain health benefits? | - Evidence suggests 150 minutes per week of moderate-to-vigorous aerobic activity—the amount tested in the new study—is effective, with additional benefits from combining aerobic and resistance exercise 6 7 10 14. - Session duration, frequency, and intensity may all influence cognitive outcomes, though the optimal parameters remain under investigation, especially for adults under 60 6 10 14. |
What is the impact of aerobic and resistance exercise on brain aging and cognitive function?
The new study’s finding that regular aerobic exercise leads to a measurable reduction in brain age is consistent with extensive literature showing that physical activity—both aerobic and resistance forms—supports cognitive function and protects against age-related decline. Meta-analyses and randomized controlled trials have repeatedly demonstrated that exercise reduces the risk of dementia and improves cognitive test scores in midlife and older adults 1 3 11 14.
- Aerobic exercise in particular is linked with improved memory, executive function, and global cognition in both healthy and at-risk populations 1 3 6 14.
- Resistance exercises yield additional benefits, especially regarding executive function and structural brain preservation 4 14.
- Longitudinal and observational studies confirm that physically active adults experience slower declines in memory and executive function over time 9.
- The magnitude of cognitive benefit, while modest, is believed to be clinically meaningful, especially when accumulated over decades 1 3.
How do exercise-induced changes in brain structure relate to cognitive outcomes?
Improvements in brain structure—such as increased hippocampal volume or preserved gray matter—are frequently observed following exercise interventions and are thought to mediate cognitive benefits. However, the relationship is complex; not all studies find direct links between fitness gains and brain structural changes 11 12.
- Aerobic exercise has been shown to increase hippocampal volume and slow gray matter loss, correlating with better spatial memory and executive function 1 11.
- Some RCTs report broad cognitive improvements in exercisers even when brain volume changes are not statistically significant, suggesting subtle or slow structural adaptation 11 12.
- Multicomponent and exergame interventions may improve executive function without detectable changes in brain volume over short durations 12.
- The use of “brain age” as an MRI-derived marker provides a comprehensive, biologically relevant endpoint that may capture subtle exercise effects earlier than clinical cognition changes 1 11.
What mechanisms may mediate the effects of exercise on the aging brain?
While the exact biological pathways remain under investigation, converging evidence suggests several mechanisms by which exercise positively influences the aging brain. These include increased neurotrophic factors, neurogenesis, improved vascular health, and systemic anti-inflammatory effects 1 2 5 13.
- Animal studies have shown that blood factors induced by exercise can transfer cognitive and neurogenic benefits to sedentary animals, implicating a systemic mechanism 2.
- Human studies link exercise with increased brain-derived neurotrophic factor (BDNF) and other molecular markers of neuroplasticity 1 5.
- Improved cerebrovascular function and reduced vascular risk factors may also underlie exercise’s protective effects on cognition 5.
- The precise interplay of these mechanisms, and their relevance at different life stages or in different populations, remains a focus of ongoing research 13.
What are the optimal exercise prescriptions for cognitive and brain health benefits?
Current guidelines recommend at least 150 minutes per week of moderate-to-vigorous aerobic exercise, a prescription validated by multiple reviews and tested in the new study 6 7 14. However, there is growing interest in refining these recommendations to maximize cognitive and brain benefits.
- Both aerobic and resistance exercise modalities appear beneficial, with some evidence favoring multicomponent or combined approaches 6 8 14.
- Session duration (45–60 minutes), frequency, and intensity all influence outcomes, but the optimal dose-response relationship—especially in midlife adults—remains unclear 10 14.
- For individuals with cognitive impairment, higher-frequency, shorter-duration sessions may yield the greatest cognitive gains 10.
- Longer studies are needed to determine if short-term brain age reductions translate into sustained protection against dementia or cognitive decline 1 10.
Future Research Questions
Although the current study adds valuable evidence linking regular exercise to healthier brain aging in midlife, important questions remain. Further research is needed to clarify the biological mechanisms involved, optimize exercise prescriptions for different populations, and determine whether changes in brain age measured by MRI translate to long-term reductions in dementia risk or cognitive impairment.
| Research Question | Relevance |
|---|---|
| Do exercise-induced reductions in brain age predict lower risk of dementia or cognitive decline later in life? | Understanding whether MRI-estimated brain age improvements translate to real-world clinical outcomes is essential for evaluating the long-term impact of exercise interventions 1 9. |
| What biological mechanisms mediate the effects of exercise on brain aging? | Clarifying the molecular and cellular pathways by which exercise influences brain structure and function could help develop targeted interventions or biomarkers 2 5 13. |
| Are certain types or doses of exercise more effective for preserving brain health in midlife? | Determining the optimal exercise prescription for different age groups, including the role of resistance versus aerobic training, could improve public health recommendations 4 6 10 14. |
| How do exercise effects on brain structure and function vary by sex, genetics, or baseline health status? | Individual differences may modulate responsiveness to exercise, and tailoring interventions could enhance effectiveness and equity 9 13. |
| Can multicomponent exercise interventions combining aerobic, resistance, and cognitive training produce greater brain health benefits than aerobic exercise alone? | Some evidence suggests that combining exercise modalities may provide additive or synergistic effects on cognitive function and brain structure 8 12 14. |