New research published this week in JAMA Network Open adds to a growing body of evidence linking lifestyle to brain health, specifically identifying key periods when physical activity appears most protective against dementia.A long-term study following over 4,300 participants in the Framingham Heart Study found those with higher activity levels in mid- and late-life experienced a greater than 40% reduction in dementia risk. The findings underscore the potential for preventative measures as dementia diagnoses continue to rise globally.
Study Links Mid- to Late-Life Physical Activity to Lower Dementia Risk
People who maintain higher levels of physical activity during middle and older age may have a significantly reduced risk of developing dementia, according to a new study. The research highlights the importance of lifestyle factors in brain health and offers potential strategies for delaying or preventing cognitive decline, a growing public health concern.
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Researchers at Boston University School of Medicine followed over 4,300 participants from the Framingham Heart Study, a long-term research project, and found that individuals with higher physical activity levels in mid-life (ages 45-64) and late-life (age 65 and older) had a more than 40% lower risk of developing dementia compared to those with lower activity levels. The findings were published November 20, 2025, in JAMA Network Open.
The study indicated that higher levels of physical activity during both mid-life and late-life were associated with similar reductions in the risk of both all-cause dementia and Alzheimer’s disease. These results could be important for determining the optimal timing for interventions aimed at preventing or delaying the onset of dementia.
A physically active lifestyle is already known to have protective effects against dementia. The Lancet Commission has previously estimated that managing 14 modifiable risk factors could prevent 45% of dementia cases, with mid-life physical activity identified as one of those key factors.
While it’s understood that physical activity is beneficial, researchers wanted to pinpoint *when* during adulthood activity levels have the most significant impact on dementia risk. The current study aimed to examine the relationship between physical activity levels during early adulthood (ages 26-44), mid-life (45-64), and late-life (65-88) and the risk of dementia.
The research team tracked the participants – 1,526 in early adulthood, 1,943 in mid-life, and 885 in late-life – for a period of 14.5 to 37.2 years, monitoring their physical activity levels and tracking the incidence of all-cause dementia and Alzheimer’s disease.
During the follow-up period, 567 cases of all-cause dementia and 369 cases of Alzheimer’s disease were identified. Participants were divided into five groups (Q1-Q5) based on their physical activity levels, ranging from the lowest 20% to the highest 20%, and dementia risk was compared across these groups.
The results showed that participants in the top 40% for mid-life physical activity (groups Q4 and Q5) had a 40% and 41% lower risk of all-cause dementia, respectively, compared to those in the lowest 20% (Q1).
Similarly, in late-life, participants in the top 40% for physical activity (Q4 and Q5) had a 36% and 45% lower risk of all-cause dementia compared to those in the lowest 20% (Q1).
However, no significant association was observed between physical activity levels in early adulthood (ages 26-44) and dementia risk.
The researchers state that this study is among the first to evaluate the critical timing of physical activity in relation to dementia risk. They suggest that increasing physical activity in mid- and late-life may help delay or prevent the onset of dementia.
◆ Source: JAMA Network Open, Phillip H. Hwang et al., ‘Physical Activity Over the Adult Life Course and Risk of Dementia in the Framingham Heart Study’
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