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Physical activity and risk of neurodegenerative disease: a systematic review of prospective evidence

  • M. Hamer (a1) and Y. Chida (a1)
  • DOI:
  • Published online: 01 June 2008

The association between physical activity and risk of neurodegenerative diseases is not well established. We therefore aimed to quantify this association using meta-analytical techniques.


We searched Medline, the Cochrane Database of Systematic Reviews and Web of Science databases from 1990 to 2007 for prospective epidemiological studies of physical activity and incident dementia, Alzheimer's and Parkinson's disease. We excluded studies of physical activity and cognitive decline without diagnosis of a neurodegenerative disease. Information on study design, participant characteristics, measurement of exposure and outcome variables, adjustment for potential confounding, and estimates of associations was abstracted independently by the two investigators.


We included 16 prospective studies in the overall analysis, which incorporated 163797 non-demented participants at baseline with 3219 cases at follow-up. We calculated pooled relative risk (RR) using a random effects model. The RR of dementia in the highest physical activity category compared with the lowest was 0.72 [95% confidence interval (CI) 0.60–0.86, p<0.001], for Alzheimer's, 0.55 (95% CI 0.36–0.84, p=0.006), and for Parkinson's 0.82 (95% CI 0.57–1.18, p=0.28).


Our results suggest that physical activity is inversely associated with risk of dementia. Future studies should examine the optimal dose of physical activity to induce protection, which presently remains unclear.

Corresponding author
*Address for correspondence: M. Hamer, Ph.D., Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK. (Email:
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

RD Abbott , LR White , GW Ross , KH Masaki , JD Curb , H Petrovitch (2004). Walking and dementia in physically capable elderly men. Journal of the American Medical Association 292, 14471453.

PA Adlard , VM Perreau , V Pop , CW Cotman (2005). Voluntary exercise decreases amyloid load in a transgenic model of Alzheimer's disease. Journal of Neuroscience 25, 42174221.

MS Albert , K Jones , CR Savage , L Berkman , T Seeman , D Blazer , JW Rowe (1995). Predictors of cognitive change in older persons: MacArthur studies of successful aging. Psychology and Aging 10, 578589.

CB Begg , JA Berlin (1989). Publication bias and dissemination of clinical research. Journal of the National Cancer Institute 81, 107115.

GA Broe , H Creasey , AF Jorm , HP Bennett , B Casey , LM Waite , DA Grayson , J Cullen (1998). Health habits and risk of cognitive impairment and dementia in old age: a prospective study on the effects of exercise, smoking and alcohol consumption. Australian and New Zealand Journal of Public Health 22, 621623.

D Carmelli , GE Swan , T Reed , BL Miller , C DeCarli (1999). Midlife cardiovascular risk factors and brain morphology in identical older male twins. Neurology 52, 11191124.

H Chen , SM Zhang , MA Schwarzschild , MA Hernan , A Ascherio (2005). Physical activity and the risk of Parkinson disease. Neurology 64, 664669.

S Colcombe , AF Kramer (2003). Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychological Science 14, 125130.

CW Cotman , NC Berchtold (2002). Exercise: a behavioral intervention to enhance brain health and plasticity. Trends in Neurosciences 25, 295301.

CW Cotman , NC Berchtold , L-A Christie (2007). Exercise builds brain health: key roles of growth factor cascades and inflammation. Trends in Neurosciences 30, 464472.

DS Day (2008). Exercise physiologists talk about sex differences. Medicine and Science in Sports and Exercise 40, 646647.

R Dersimonian , N Laird (1986). Meta-analysis in clinical trials. Controlled Clinical Trials 7, 177188.

C Fabrigoule , L Letenneur , JF Dartigues , M Zarrouk , D Commenges , P Barberger-Gateau (1995). Social and leisure activities and risk of dementia: a prospective longitudinal study. Journal of the American Geriatrics Society 43, 485490.

W Farris , S Mansourian , Y Chang , L Lindsley , EA Eckman , MP Frosch , CB Eckman , RE Tanzi , DJ Selkoe , S Guenette (2003). Insulin-degrading enzyme regulates the levels of insulin, amyloid beta-protein, and the beta-amyloid precursor protein intracellular domain in vivo. Proceedings of the National Academy of Sciences USA 100, 41624167.

SC Ho , J Woo , A Sham , SG Chan , AL Yu (2001). A 3-year follow-up study of social, lifestyle and health predictors of cognitive impairment in a Chinese older cohort. International Journal of Epidemiology 30, 13891396.

M Kivipelto , T Ngandu , L Fratiglioni , M Viitanen , I Kareholt , B Winblad , EL Helkala , J Tuomilehto , H Soininen , A Nissinen (2005). Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Archives of Neurology 62, 15561560.

AF Kramer , SJ Colcombe , E McAuley , PE Scalf , KI Erickson (2005). Fitness, aging and neurocognitive function. Neurobiology of Aging 26 (Suppl. 1), 124127.

EB Larson , L Wang , JD Bowen , WC McCormick , L Teri , P Crane , W Kukull (2006). Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of Internal Medicine 144, 7381.

D Laurin , R Verreault , J Lindsay , K MacPherson , K Rockwood (2001). Physical activity and risk of cognitive impairment and dementia in elderly persons. Archives of Neurology 58, 498504.

O Lazarov , J Robinson , YP Tang , IS Hairston , Z Korade-Mirnics , VM Lee , LB Hersh , RM Sapolsky , K Mirnics , SS Sisodia (2005). Environmental enrichment reduces Abeta levels and amyloid deposition in transgenic mice. Cell 120, 701713.

RT Linn , PA Wolf , DL Bachman , JE Knoefel , JL Cobb , AJ Belanger , EF Kaplan , RB D'Agostino (1995). The ‘preclinical phase’ of probable Alzheimer's disease. A 13-year prospective study of the Framingham cohort. Archives of Neurology 52, 485490.

ME Lytle , J Vander Bilt , RS Pandav , HH Dodge , M Ganguli (2004). Exercise level and cognitive decline: the MoVIES project. Alzheimer Disease and Associated Disorders 18, 5764.

BL Marks , DJ Madden , B Bucur , JM Provenzale , LE White , R Cabeza , SA Huettel (2007). Role of aerobic fitness and aging on cerebral white matter integrity. Annals of the New York Academy of Sciences 1097, 171174.

LJ Podewils , E Guallar , N Beauchamp , CG Lyketsos , LH Kuller , P Scheltens (2007). Physical activity and white matter lesion progression: assessment using MRI. Neurology 68, 1223–126.

LJ Podewils , E Guallar , LH Kuller , LP Fried , OL Lopez , M Carlson , CG Lyketsos (2005). Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. American Journal of Epidemiology 161, 639651.

M Richards , R Hardy , ME Wadsworth (2003). Does active leisure protect cognition? Evidence from a national birth cohort. Social Science and Medicine 56, 785792.

C Rosendorff , MS Beeri , JM Silverman (2007). Cardiovascular risk factors for Alzheimer's disease. American Journal of Geriatric Cardiology 16, 143149.

S Rovio , I Kareholt , EL Helkala , M Viitanen , B Winblad , J Tuomilehto , H Soininen , A Nissinen , M Kivipelto (2005). Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease. Lancet Neurology 4, 705711.

A Singh-Manoux , M Hillsdon , E Brunner , M Marmot (2005). Effects of physical activity on cognitive functioning in middle age: evidence from the Whitehall II prospective cohort study. American Journal of Public Health 95, 22522258.

BJ Small , L Fratiglioni , M Viitanen , B Winblad , L Backman (2000). The course of cognitive impairment in preclinical Alzheimer disease: 3- and 6-year follow-up of a population-based sample. Archives of Neurology 57, 839844.

MT Sturman , MC Morris , CF Mendes de Leon , JL Bienias , RS Wilson , DA Evans (2005). Physical activity, cognitive activity, and cognitive decline in a biracial community population. Archives of Neurology 62, 17501754.

A Sumic , YL Michael , NE Carlson , DB Howieson , JA Kaye (2007). Physical activity and the risk of dementia in oldest old. Journal of Aging and Health 19, 242259.

BM van Gelder , MA Tijhuis , S Kalmijn , S Giampaoli , A Nissinen , D Kromhout (2004). Physical activity in relation to cognitive decline in elderly men: the FINE Study. Neurology 63, 23162321.

J Verghese , RB Lipton , MJ Katz , CB Hall , CA Derby , G Kuslansky , AF Ambrose , M Sliwinski , H Buschke (2003). Leisure activities and the risk of dementia in the elderly. New England Journal of Medicine 348, 25082516.

JY Wang , DH Zhou , J Li , M Zhang , J Deng , M Tang , C Gao , J Li , Y Lian , M Chen (2006). Leisure activity and risk of cognitive impairment: the Chongqing aging study. Neurology 66, 911913.

J Weuve , JH Kang , JE Manson , MM Breteler , JH Ware , F Grodstein (2004). Physical activity, including walking, and cognitive function in older women. Journal of the American Medical Association 292, 14541461.

RS Wilson , DA Bennett , JL Bienias , NT Aggarwal , CF Mendes De Leon , MC Morris , JA Schneider , DA Evans (2002). Cognitive activity and incident AD in a population-based sample of older persons. Neurology 59, 19101914.

K Yaffe , D Barnes , M Nevitt , LY Lui , K Covinsky (2001). A prospective study of physical activity and cognitive decline in elderly women: women who walk. Archives of Internal Medicine 161, 17031708.

M Yamada , F Kasagi , H Sasaki , N Masunari , Y Mimori , G Suzuki (2003). Association between dementia and midlife risk factors: the Radiation Effects Research Foundation Adult Health Study. Journal of the American Geriatrics Society 51, 410414.

T Yoshitake , Y Kiyohara , I Kato , T Ohmura , H Iwamoto , K Nakayama , S Ohmori , K Nomiyama , H Kawano , K Ueda , K Sueishi , M Tsuneyoshi , M Fujishima (1995). Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population: the Hisayama Study. Neurology 45, 11611168.

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