Regular physical activity in midlife is linked to better brain health later on. But scientists still don’t fully understand how aerobic exercise affects the brain earlier in adulthood. A new study from the Advent Health Research Institute examined this connection and found that regular aerobic exercise may help the brain remain biologically younger. This could lead to sharper thinking, stronger memory, and better overall mental well-being.
Early to midlife is a crucial stage where lifestyle choices can shape brain health. Health issues like high blood pressure and obesity raise dementia risk, while regular exercise helps protect the brain. But most studies look at older adults, leaving early and midlife brain health less understood.
Most studies on exercise and brain health have focused on specific regions, such as the hippocampus or prefrontal cortex, rather than on overall brain aging. Researchers now suggest using brain-predicted age difference (brain-PAD), which compares a person’s actual age with their “brain age.”
This marker shows how much younger or older the brain appears and is more sensitive than traditional scans. Machine learning enables the detection of subtle changes in brain structure, especially in early and mid-adulthood, when differences are harder to spot.
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In the eBACH study, 130 healthy adults (ages 26–58) took part in a year-long trial. They were randomly assigned to either a moderate-to-vigorous aerobic exercise program or a health information control group, with allocation balanced by age and sex.
The exercise group trained about 150 minutes per week, with two supervised 60‑minute sessions plus home workouts. They used equipment like treadmills, bikes, ellipticals, stair climbers, and rowers, with intensity matched to their fitness levels. Researchers measured brain structure using MRI scans and tested cardiorespiratory fitness (VO₂peak) at baseline and after 12 months.
After one year, the exercise group’s brains looked younger, with brain age dropping by about 0.6 years. The control group’s brains appeared slightly older (+0.35 years), though not significantly so. Overall, the difference between groups was nearly one year, favoring those who exercised.
“Even though the difference is less than a year, prior studies suggest that each additional ‘year’ of brain age is associated with meaningful differences in later-life health,” said Dr. Kirk I. Erickson, senior author of the study and a neuroscientist and director at AdventHealth Research Institute and the University of Pittsburgh. “From a lifespan perspective, nudging the brain in a younger direction in midlife could be very important.”
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Higher fitness levels were linked to younger-looking brains. For every standard increase in VO₂peak (about 7 mL/kg/min), brain age appeared nearly 2 years younger. This suggests that staying fit may protect the brain from midlife aging, supporting past research that ties physical activity and cardiorespiratory fitness to healthier brain structure.
Researchers tested whether changes in fitness (CRF), body composition, blood pressure, or BDNF explained the exercise effect on brain age. While fitness improved in the exercise group (+1.6 mL/kg/min) and declined slightly in controls, these changes did not significantly account for the brain-PAD differences.
“That was a surprise,” Wan noted. “We expected improvements in fitness or blood pressure to account for the effect, but they didn’t. Exercise may be acting through additional mechanisms we haven’t captured yet, such as subtle changes in brain structure, inflammation, vascular health, or other molecular factors.”
The study suggests that more research with larger groups is needed to understand how exercise benefits brain age in early to midlife. While tested mediators didn’t fully explain the effect, other biological pathways, like reduced inflammation, improved mitochondrial function, stronger blood vessel health, and better metabolism, may play a role in lowering brain-PAD.
Journal Reference:
- Lu Wan, Cristina Molina-Hidalgo, Mary E. Crisafio, George Grove, Regina L. Leckie, Thomas W. Kamarck, Chaeryon Kang, Mia DeCataldo, Anna L. Marsland, Matthew F. Muldoon, Mark R. Scudder, Javier Rasero, Peter J. Gianaros, Kirk I. Erickson. Fitness and exercise effects on brain age: A randomized clinical trial. Journal of Sport and Health Science, 2026; 15: 101079 DOI: 10.1016/j.jshs.2025.101079