Effects of Exercise on the Brain

A review of

Wan L, Molina-Hidalgo C, Crisafio ME, et al. (2025). Fitness and exercise effects on brain age: A randomized clinical trial. J Sport Health Sci 2025, 101079.

Reviewed by Dr. Justin Thompson

A Summarized Review of the Conclusion

Participating in a year-long routine of moderate to vigorous aerobic activities helped improve brain health in adults by actually making their brains appear younger than their actual age. The study found that people who increased their cardiorespiratory fitness saw this positive change, reinforcing the connection between physical fitness and a younger, healthier brain. These results add important evidence to the limited research about how exercise affects brain health in adults before old age, confirming that aerobic exercise protects the brain from aging faster than normal. In fact, the drop in brain-predicted age that followed the exercise program suggests that staying active can help the brain resist age-related changes, possibly lowering the risk for dementia later in life. Still, more research is needed to figure out exactly how exercise changes brain age, which could point scientists toward new ways to slow down brain aging in the future.

Quotes from the Article

“Every standard deviation increase in VO₂peak (about 7 mL/kg/min) was associated with approximately 1.83 years decrease in brain-PAD.”

“After 12 months, the brain-PAD of participants in the exercise group decreased by an average of 0.6 years.”

“None of the proposed pathways statistically mediated the effect of exercise on brain-PAD.”

“This randomized controlled trial helps to elucidate the causal relationship between cardiorespiratory fitness, exercise, and brain health.”

Introduction to The Research

The introduction frames the study around the concern that brain aging, a process detectable by neuroimaging markers, can precede cognitive decline long before symptoms appear. The authors discuss how previous evidence links cardiorespiratory fitness and regular physical activity to overall good brain health and slower aging, but few randomized clinical trials have directly tested this connection using robust imaging metrics. The study aims to fill this gap by investigating whether sustained aerobic exercise can slow or reverse signs of brain aging in healthy adults.

Research Methodology

Researchers conducted a randomized controlled trial involving 130 healthy adults, aged 26-58, assigning participants to either a year-long supervised moderate-to-vigorous aerobic exercise program or to a control group maintaining regular activity. Cardiorespiratory fitness was measured by VO₂peak, and brain age was estimated via MRI-based algorithms that predict age from structural scans. Analyses accounted for variables like blood pressure, body composition, and levels of brain-derived neurotrophic factor to explore possible mechanisms linking exercise and brain health.

Research Findings

The study found that participants who completed higher levels of aerobic exercise demonstrated significant improvements in cardiorespiratory fitness and a reduction in “brain-predicted age difference,” meaning their brains showed characteristics younger than their chronological age. Specifically, the exercise group saw an average 0.6 year decrease in brain-PAD; statistically, each standard deviation improvement in fitness correlated with nearly two years’ reduction in brain age. The effect was not explained by changes in body composition, blood pressure, or brain-derived neurotrophic factor, suggesting unique biological mechanisms may be at play.

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