Midlife activity could mean better brain health

A new study suggests greater amounts of moderate-to-vigorous intensity physical activity like walking briskly, running and biking in middle age through later life may have a protective effect on the brain.

The study, published in the January 6, 2021, online issue of Neurology®, the medical journal of the American Academy of Neurology, found that more physical activity during these phases of life is associated with less brain damage 25 years later.

“Our study suggests that getting at least an hour and 15 minutes of moderate-to-vigorous intensity physical activity a week or more during midlife may be important throughout your lifetime for promoting brain health and preserving the actual structure of your brain,” said study author Priya Palta, Ph.D., of Columbia University Irving Medical Center in New York City. “In particular, engaging in more than 2-1/2 hours of physical activity per week in middle age was associated with fewer signs of brain disease.”

The study involved 1,604 people with an average age of 53 who attended five physical examinations over 25 years. Participants rated their weekly activity levels once at the start and again at two additional times. Each person reported the amount of time they engaged in moderate-to-vigorous intensity physical activity, which researchers classified as none, low, middle or high.

Researchers then used brain scans to measure participants’ grey and white brain matter and lesions, or areas of injury or disease in the brain, at the end of the study.

After adjusting for demographics and lifestyle factors, people who reported no moderate-to-vigorous intensity physical activity in midlife had an average 47% greater odds of developing brain lesions, or small areas of brain damage, 25 years later than people who reported high levels of moderate-to-vigorous intensity physical activity.

Researchers used brain scans to measure the amount of damage to the brain’s white matter. White matter is tissue composed of nerve fibers that connect different brain regions. After adjusting for demographic and lifestyle factors, higher activity levels were associated with more intact white matter in the brain.

Specifically, researchers looked at movement of water molecules in the brain tissue. Participants who reported high moderate-to-vigorous intensity physical activity in midlife had movement that was more beneficial by 0.13 standard deviations, compared to participants who reported no moderate-to-vigorous intensity physical activity in midlife.

“Our results show that staying active during midlife may have real brain benefits,” Palta said. “In particular, consistently high levels of midlife moderate-to-vigorous intensity physical activity were associated with fewer brain lesions in later life.”

Other research has shown that brain lesions may be caused by inflammation or other damage to the small blood vessels in the brain. “Our research suggests that physical activity may impact cognition in part through its effects on small vessels in the brain. This study adds to the body of evidence showing that exercise with moderate-to-vigorous intensity is important for maintaining thinking skills throughout your lifetime,” Palta said.

A limitation of the study is that it relied on participants reporting their own physical activity, which could be inaccurate. Also, researchers did not include physical activity other than leisure time activity, such as work-related or incidental activity.


This study was supported by the National Heart, Lung, and Blood Institute and the National Institute of Aging of the National Institutes of Health. Learn more about brain health at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

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