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Small amounts of moderate to vigorous physical activity are associated with big reductions in dementia risk

Even frail or nearly frail older adults might be able to reduce their dementia risk through low-dose exercise.

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A little movement could help prevent dementia, even for frail older adults, suggests a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health.

The researchers found that engaging in as little as 35 minutes of moderate to vigorous physical activity per week, compared to zero minutes per week, was associated with a 41% lower risk of developing dementia over an average four-year follow-up period. Even for frail older adults—those at elevated risk of adverse health outcomes—greater activity was associated with lower dementia risks.  

The researchers found dementia risk decreased with higher amounts of physical activity. Dementia risks were 60% lower in participants in the 35 to 69.9 minutes of physical activity/week category; 63% lower in the 70 to 139.9 minutes/week category; and 69% lower in the 140 and over minutes/week category.

For their analysis, the researchers analyzed a dataset covering nearly 90,000 adults living in the U.K. who wore smart-watch-type activity trackers. 

The study was published online January 15 in the Journal of the American Medical Directors Association.

“Our findings suggest that increasing physical activity, even as little as five minutes per day, can reduce dementia risk in older adults,” says study lead author Amal Wanigatunga, PhD, MPH, assistant professor in the Bloomberg School’s Department of Epidemiology. Wanigatunga is also a core faculty member at the Johns Hopkins Center on Aging and Health and has a joint appointment at the Johns Hopkins University School of Medicine. “This adds to a growing body of evidence that some exercise is better than nothing, especially with regard to an aging-related disorder that affects the brain that currently has no cure.”

Dementia, usually from Alzheimer’s disease, is one of the most common conditions of old age. It is estimated to affect about seven million people in the U.S., including about a third of those who are 85 years or older. Although the risk of dementia rises with age, studies in recent years have suggested that dementia is somewhat preventable, within a normal lifespan, by lifestyle changes that include better control of cholesterol, blood pressure and blood sugar, and being more active.

The minimum amount of activity needed to reduce dementia risk meaningfully isn’t yet clear. For many older individuals, especially frail ones, the high amounts of exercise recommended in official guidelines are unattainable and may discourage any exercise at all. Both the U.S. Department of Health and Human Services and the U.K. National Health System recommend that adults get at least 150 minutes of moderate intensity exercise per week, an average of 20 minutes per day.

For their study, Wanigatunga analyzed data on British adults generated as part of the UK Biobank project, a long-running, ongoing study of approximately 500,000 individuals. The dataset for the new study covered 89,667 adults, mostly in their 50s and older, who used wrist-worn accelerometers to track their physical activity for a week during the period from February 2013 to December 2015. Follow-up of their health status extended for an average of 4.4 years, through November 2021, during which 735 of the participants were diagnosed with dementia.

The analysis compared individuals whose trackers showed some weekly moderate to vigorous physical activity to those whose trackers showed none and accounted for age and other medical conditions. The associations between higher activity and lower dementia risk were striking. Participants in the lowest activity category, ranging from one to 34.9 minutes per week, had an apparent risk reduction of about 41%.

When the researchers took into account participants who met their definitions of frailty or “pre-frailty,” they found that the association between more activity and less dementia was essentially unchanged.

“This suggests that even frail or nearly frail older adults might be able to reduce their dementia risk through low-dose exercise,” Wanigatunga says.

Wanigatunga notes that the study was not a clinical trial that established causation indicating that exercise reduces dementia risk, but its findings are consistent with that hypothesis. To check the possibility that their findings reflected undiagnosed dementia leading to lower physical activity, the researchers repeated their analysis but excluded dementia diagnoses in the first two years of follow-up. The association between more activity and lower dementia risk remained robust.

Wanigatunga and his colleagues recommend that future clinical trial-type studies investigate low-dose exercise as an important initial step towards increasing physical activity as a dementia-preventing strategy.

“Moderate-to-Vigorous Physical Activity at Any Dose Reduces All-Cause Dementia Risk Regardless of Frailty Status” was co-authored by Amal Wanigatunga, Yiwen Dong, Mu Jin, Andrew Leroux, Erjia Cui, Xinkai Zhou, Angela Zhao, Jennifer Schrack, Karen Bandeen-Roche, Jeremy Walston, Qian-Li Xue, Martin Lindquist and Ciprian Crainiceanu.

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Wellness

Structured exercise linked to longer cancer survival and time free of disease

Those who exercised as part of their care were 23% less likely to die and 17% less likely to have a recurrence before death than those who didn’t exercise. Separate analyses showed that they were also 18% less likely to die from any cause, and 26% less likely to die from their cancer.

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Structured exercise may help people with cancer live longer and have more time free of disease, finds a synthesis of the available evidence, published in the British Journal of Sports Medicine.

The survival and recurrence risk benefits were strongest in early stage disease, in those who did aerobic exercise or aerobic exercise plus strength training, and in those who managed to keep up their exercise routines, the findings indicate.

Their analysis prompts the researchers to conclude that incorporating the therapeutic potential of exercise into cancer care merits consideration.

Cancer comes back in between 20%–40% of patients, even after standard curative surgery and chemotherapy, point out the researchers.

While structured exercise is widely recommended to ease fatigue and improve physical functioning and quality of life, its potential to prolong survival and stave off disease recurrence remains a subject of debate, they add.

In a bid to strengthen the evidence base, the researchers scoured research databases for randomised controlled clinical trials published up to the end of 2025 and reporting on survival and disease recurrence in adults with confirmed cancer who were given structured exercise programmes as part of their care.

From an initial haul of 123 studies, 21 clinical trials from North America, Europe, Australia, and Asia, involving a total of 8449 participants (88% women), met the eligibility criteria.

The average age of participants was 54 (range 47–76), and the average monitoring period was 64 months (range 2–99 months). The most common type of cancer studied was that of the breast followed by those of the bowel and pancreas.

Pooled data analysis of the results showed that structured exercise was associated with significant improvements in overall survival.

Those who exercised as part of their care were 23% less likely to die and 17% less likely to have a recurrence before death than those who didn’t exercise. Separate analyses showed that they were also 18% less likely to die from any cause, and 26% less likely to die from their cancer.

But there was no clear evidence that structured exercise prolonged the time before patients’ cancer worsened or increased the likelihood that no invasive cancer remained after standard treatment.

An exploratory analysis showed that the associations were stronger among participants who completed at least 70% of their exercise programme.

Overall survival estimates favoured aerobic exercise alone and programmes combining aerobic exercise and strength training. No clear association was found for strength training alone, but this finding was based only on one trial, involving 129 participants, note the researchers

“Aerobic exercise drives systemic cardiovascular conditioning, immune cell mobilisation, and normalisation of tumour perfusion, mechanisms directly relevant to systemic tumour control,” explain the researchers.

There are plausible biological explanations for the beneficial effects of exercise on cancer survival and risk of recurrence, they suggest.

Exercise may boost the body’s immune system response to cancer and improve blood flow within tumours, potentially helping treatment to work better. It may also lower circulating levels of sex specific hormones and increase glucose uptake by muscles, leaving less available to fuel cancer cells, they highlight. And it may help cells repair DNA damage, potentially limiting changes that can make tumours more aggressive, they add.

The researchers acknowledge various limitations to their findings, including the migration of participants in comparison groups to healthier behaviours; considerable variations in the type, duration, and intensity of the included exercise interventions; and a predominance of evidence from breast cancer trials, with relatively little evidence on advanced stage disease.

Nevertheless, they conclude: “Our meta-analysis provides direct, quantified evidence suggesting that the benefits of structured exercise may extend beyond supportive care to outcomes traditionally associated with therapeutic interventions, while underscoring that observed effects are context dependent and sensitive to trial design, conduct, and feasibility.”

They add: “On the strength of this evidence, clinicians can reasonably recommend structured exercise as part of oncological care, while recognising that important questions remain and that ongoing trials will continue to refine its optimal application.”

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Workout or nap? Either can help your sleepless brain, study finds

People who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither.

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A short workout or a nap can help protect memory after a sleepless night, a McGill University-led study has found.

Researchers found people who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither. The findings, published in Proceedings of the National Academy of Sciences (PNAS), point to practical ways to counter the effects of sleep deprivation.

“Sleep loss affects nearly every aspect of how we think and function, but many people can’t simply stop what they’re doing and get more sleep,” said senior author Marc Roig, Professor in McGill’s School of Physical and Occupational Therapy. “Our findings show that even a brief bout of exercise may help preserve one of our most important cognitive abilities.”

The study involved 54 healthy young adults who stayed awake for 30 consecutive hours under lab supervision. Participants were then assigned to one of three groups: a 20-minute cycling session, a 90-minute nap or a control condition. Three days later, researchers tested their memory for images they had viewed immediately after the intervention. Those who exercised or napped remembered significantly more images than participants who did neither.

Same result, different pathways

While the memory benefits were nearly identical, brain recordings revealed that exercise and napping helped in different ways.

Napping appeared to help the brain recharge, making it easier to take in and remember new information. Exercise, by contrast, helped the brain use its remaining resources more efficiently, without making participants feel more tired.

The findings could eventually inform fatigue-management strategies in workplaces where sleep loss is common and mistakes can have serious consequences, such as health care, transportation and emergency response.

“A nap isn’t always possible in the middle of a shift,” said first author Madhura Lotlikar, a doctoral candidate in McGill’s Department of Neurology and Neurosurgery. “Exercise is accessible, inexpensive and easy to implement. That makes it a promising tool to help people stay cognitively sharp when sleep is limited.”

The researchers emphasize that exercise cannot replace sleep, but it may help people function better when getting enough rest isn’t possible.

About the study

“Protecting episodic memory after sleep loss: Similar benefits of exercise and naps via distinct neural contributions” by Madhura Lotlikar and Marc Roig et al., was published in Proceedings of the National Academy of Sciences of the United States of America.

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Wellness

Walking and weight training alone are not enough for strong bones – football and handball may be more effective

Bone formation was stimulated most effectively by activities involving explosive movements, rapid changes of direction, and turning. The findings could help improve exercise programs designed to maintain bone health and prevent osteoporosis. 

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When it comes to maintaining healthy bones, how intensely we exercise may matter more than how much we exercise, according to researchers at Semmelweis University.

Their study, published in Sports Medicine – Open, found that bone formation was stimulated most effectively by activities involving explosive movements, rapid changes of direction, and turning. The findings could help improve exercise programs designed to maintain bone health and prevent osteoporosis. 

Researchers at Semmelweis University analyzed the results of 24 clinical studies involving a total of 1,238 healthy adult participants. Rather than tracking changes in bone mineral density, the studies measured substances in the blood that indicate whether the body is actively building new bone tissue. These so-called biomarkers can reflect the effects of exercise within just a few weeks, providing feedback much earlier than bone density measurements.  

“What makes our study unique is that we examined not only the type of exercise – whether endurance, resistance, or combined training – but also exercise intensity, frequency, and duration. Our goal was to determine which forms of exercise stimulate bone metabolism most effectively and which appear to be less beneficial from this perspective,” said dr. Péter Ferdinandy, Vice-Rector for Science and Innovations at Semmelweis University and senior author of the study. 

The most effective activities were high-intensity sports involving frequent explosive movements, rapid changes of direction, and turning. Recreational football and handball, for example, were associated with increases of up to 45–46 percent in the levels of substances linked to bone formation. In contrast, walking, step aerobics, and traditional gym-based resistance exercises were generally less effective.  

What should you keep in mind?
It is important not to start a high-intensity exercise program suddenly or without proper preparation. This is particularly true for people with cardiovascular, musculoskeletal, or metabolic diseases, as well as those living with osteoporosis. Before beginning a new type of exercise or a more demanding training program, they should consult their treating physician, general practitioner, or a sports medicine specialist to ensure that the activity and its intensity are appropriate for their individual health status.

“The most surprising finding was that resistance training did not produce a significant effect on markers of bone metabolism, even though several professional guidelines recommend this type of exercise for maintaining bone health. Likewise, low- or moderate-intensity endurance exercise, such as walking or jogging, showed no meaningful long-term effect,” explained Viktória Barna, PhD student at Semmelweis University and first author of the study.

This, of course, does not mean that walking or lower-intensity physical activity is without health benefits. However, if the goal is to keep bones strong and healthy for as long as possible, they appear to require a greater mechanical stimulus. 

“According to the World Health Organization, regular physical activity offers numerous health benefits. However, our findings suggest that low-intensity exercise alone is not sufficient to stimulate bone metabolism. High-intensity exercise may trigger early beneficial changes in bone formation, potentially helping to slow bone loss and support healthy ageing,” summarized dr. Nóra Sydó, clinical specialist and co-author of the study. 

According to the researchers, these findings could contribute to the development of evidence-based exercise programs aimed at maintaining bone health and preventing osteoporosis. 

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