Exercise: The Most Powerful Brain Drug You're Not Using Yet

For the past two years, I have deeply researched the risk factors and preventative measures for age-related cognitive decline. I intend to share my findings and opinions in a series of posts, starting with this relatively simple initial topic.

Exercise for brain health is the most powerful brain drug we have.

The mechanisms are wide-ranging: amyloid clearance, increased cerebral blood flow, neurogenesis, reduced neuroinflammation, improved sleep, and lower cortisol. Across decades of evidence, the bulk of trials and meta-analyses converge on a 30–45% reduction in dementia risk for regular exercisers compared with sedentary peers.

Aerobic exercise

Aerobic exercise stimulates BDNF — brain-derived neurotrophic factor, sometimes described as fertilizer for neurons — which promotes hippocampal neurogenesis. It also triggers the release of "exerkines" from the liver, proteins that strengthen the blood-brain barrier.

The dose is achievable: roughly 150 minutes per week of moderate intensity. That's 30 minutes five days a week, or 50 minutes three days a week. Brisk walking, cycling, swimming, tennis or pickleball, and dancing all count. Dancing is arguably the best of the lot — it combines aerobic load with balance and cognitive challenge in one activity.

Strength training

Two sessions per week of resistance training drives independent improvements in executive function and slowed cognitive decline. The mechanisms include IGF-1 signaling and reduced insulin resistance. Combined aerobic plus resistance training outperforms either alone. Zone 2 training is an emerging area of research worth watching.

How I do it

I'm not someone who loves to work out, but I've kept the same personal trainer three times a week for the last 30 years. She ensures the workout stays interesting and challenging by varying the routine. If she didn't show up, I wouldn't exercise. The key is finding a way to integrate it into your daily or weekly routine.

What's next

Exercise is one of the most critical parts of enhancing brain health, but it is only one of many important components. In future posts I will cover sleep, diet, hearing loss, cardiovascular health, stress, supplements, and more. For now, happy exercising.

For more information, take a look at our approach to neuroprevention.

— Robert Colton