A new peer-reviewed Viewpoint argues that exercise should be prescribed — not merely recommended — as a central part of protecting and improving brain health. The paper, published in Brain Health, calls for doctors to treat physical activity as a medical intervention, with clear targets for type, frequency, intensity, duration, safety considerations and a follow-up plan.
According to Alzheimer's Research UK, the UK's leading dementia research charity, "we should take its potential impact far more seriously." The comments follow the publication of the new perspective, which suggests exercise should be a structured part of care for "brain health."
Exercise as a medical intervention
"We still tend to treat exercise as general lifestyle advice," said Dr Zhou, the corresponding author. "The evidence we reviewed supports something more deliberate: a prescription that names the type of activity, the frequency, the intensity, the duration, the safety considerations, and a plan for follow-up, just as we would for a medication."
In its introduction, the study explains that "brain health refers to the maintenance of cognitive, emotional, behavioral, and social functioning across the life course. Exercise can support several domains relevant to brain health, including cognition, mood, sleep, motivation, social functioning, and resilience."
"Unfortunately, in clinical practice, exercise is too often treated as simply lifestyle advice rather than as a structured intervention that can contribute to prevention, treatment, and recovery in brain-related disorders."
Recommended activity levels
The World Health Organization (WHO) recommends 150 to 300 minutes of moderate-intensity aerobic activity per week for adults, plus 75 to 150 minutes of vigorous activity and muscle strengthening on at least two days. However, this is not achievable for everyone, as anxiety, depression, low energy after work, problems at home, or a general dip in motivation can all get in the way.
For many, the first step might be small. People can aim to start with a five-minute walk, chair-based movements, a supervised group, or something already built into the day — like walking the dog — and gradually build up their exercise routine, where possible.
Nicholas Fabiano, MD, of the Department of Psychiatry at the University of Ottawa and one of the researchers behind the study, stresses: "The starting point does not have to be impressive. It has to be possible. Small, repeated successes build self-efficacy and habit. That is what creates the conditions for sustained activity."
Evidence on mental health and dementia
Drawing on randomised trials, meta-analyses and cohort studies, the experts make a case for exercise's positive effects on mental health, highlighting reductions in depressive symptoms. There was also a reduction in symptoms of anxiety, psychological distress and suicide-related outcomes. The study further highlights links between physical activity and lower risks of cognitive impairment, all-cause dementia and Alzheimer's disease, in line with recommendations from the WHO.
It is worth noting that the evidence linking physical activity to reduced dementia risk remains largely observational. This means exercise cannot confidently be "prescribed" for dementia prevention in the same way researchers advocate for in the case of other brain health concerns.
Response from Alzheimer's Research UK
Dr Honorine Lebraud, Senior Partnerships Manager at Alzheimer's Research UK, said: "Exercise is an incredibly important tool for supporting brain health, and we should take its potential impact far more seriously. When it comes to dementia, the evidence is encouraging. The World Health Organisation already recognises physical activity as an important way to reduce dementia risk."
"However, while exercise should be part of everyone's routine, it cannot guarantee protection against dementia or be relied upon as the only way to reduce risk. There are other important steps we can take to support our brain health. Beyond exercise, this includes eating a healthy diet, keeping blood pressure under control and regularly socialising. It's never too late to make positive changes."
The peer-reviewed Viewpoint, titled "Exercise is critical for brain health," is freely available via Open Access starting on November 3, 2026, in Brain Health. The full reference is Zhou C, Wong S, Fabiano N. Exercise is critical for brain health. Brain Health 2026. DOI: https://doi.org/10.61373/bh026v.0027. Epub 2026 Nov 3.
