Aging and diabetes are two risk factors for cognitive decline. Worldwide, the population is aging, and metabolic syndrome increases with age. This has sparked intense interest from patients, caregivers, and medical professionals for strategies to stem the tide. Exercise is one simple, yet effective, strategy. A recent review of medical journal articles adds credence to the need for lifestyle and exercise prescriptions in primary care, including activities such as aerobic exercise, cycling, resistance training, tai chi, yoga, and others, based on their effect upon the brain.

How does exercise affect the brain? In one study on older adults, areas of the brain most associated with aging and cognitive decline—the prefrontal region, governing executive function, and the temporal region, involved in long-term memory—were the same areas most affected by exercise. Exercise increased the volume of the hippocampus, slowing age-related brain atrophy (tissue destruction) while also slowing the progression from mild cognitive impairment to Alzheimer’s disease. Exercise also increased the volume of brain tissue in the frontal and temporal lobes of the brain.In addition to these salutary physical changes, seniors who consistently engaged in some form of physical activity were better able to maintain their cognitive function, focused attention, and memory compared to their sedentary peers.

Exercise also changes chemical signaling in the brain, even in the short term. An analysis of non-insulin dependent elderly diabetic men examined the effects of exercise on proteins affecting nervous tissue growth.5 Participants engaged in 30 minutes of either submaximal cycling or the activity of playing video games that involve physical exertion, with similar effects on heart rate. Cyclistts had a 20% increase in brain-derived neurotrophic factor, a key protein in neuroplasticity, and a 14% increase in vascular endothelial growth factor, a key protein involved in the generation of nerve tissue (neurogenesis). This suggests that different types of exercise may be useful for different conditions.

In addition to the immediate, beneficial effects of exercise, longer-term exercise also has beneficial effects. For instance, in seniors with mild reduced blood flow in the brain causing cognitive impairment, aerobic training three times a week for six months changed both brain structure and executive functioning. These seniors experienced improvement in completing tasks that require executive function. 

Overall, the benefits of exercise are indisputable. For patients concerned about or in the midst of cognitive decline, exercise will be particularly beneficial. CLICK HERE for our page on Alzheimer’s Disease and Dementia.

(Derived from an article by Institute for Functional Medicine)


  1. United Nations Department of Economic and Social Affairs Population Division. World Population Ageing: 1950-2050. New York, NY: United Nations; 2002.
  2. Ford ES, Li C, Zhao G. Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes. 2010;2(3):180-93. doi: 1111/j.1753-0407.2010.00078.x.
  3. Chieffi S, Messina G, Villano I, et al. Neuroprotective effects of physical activity: evidence from human and animal studies. Front Neurol. 2017;8:188. doi: 10.3389/fneur.2017.00188.
  4. Brinkmann C, Schäfer L, Masoud M, et al. Effects of cycling and exergaming on neurotrophic factors in elderly type 2 diabetic men – a preliminary investigation. Exp Clin Endocrinol Diabetes. 2017;125(7):436-40. doi: 10.1055/s-0043-103967.
  5. Hsu CL, Best JR, Davis JC, et al. Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment. Br J Sports Med. 2017 Apr 21. doi: 10.1136/bjsports-2016-096846.

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