Document Type : Review Article


1 School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, Room 3.01, Addison House, Guy’s Campus, London, SE1 1UL, King’s College London, United Kingdom

2 King’s Undergraduate Medical Education in the Community (KUMEC), Centre for Education, GKT School of Medical Education, Faculty of Life Sciences & Medicine, Room 4.02, Addison House, Guy’s Campus, London, SE1 1UL, King’s College London, United Kingdom


Background: Each year, twice as many women than men are diagnosed with Alzheimer’s Disease (AD). As there is no known cure for AD, preventing it has become a vital public health issue. One lifestyle intervention that may reduce the risk of AD is physical activity (PA). This scoping review aimed to examine the existing literature on PA and AD risk to identify whether PA has a sex-specific effect on AD risk in women.
Methods: A scoping review was conducted based on PRISMA-ScR guidelines. Cochrane recommended databases, MEDLINE, Embase, and PsycINFO were searched via Ovid between May and June 2022. Articles were screened at the title, abstract, and full-text level for inclusion criteria (female participants, results reported by sex, PA, or exercise reported separately from other variables, and participants with no known cognitive impairment). For each study, sample characteristics, PA and AD measures, follow-up times, and results were summarized.
Results: Ten studies met the inclusion criteria, and their results were assessed for quality using the Cochrane GRADE tool. Most studies (80%) reported significant results for females. When broken down by sex, six studies reported differences in result significance with some studies finding that PA can reduce AD risk in women but not in men. Increased weekly PA sessions, duration, and intensity all significantly reduced AD risk for women.
Conclusion: While there are some limitations, including reliance on self-report, short follow-up times, and variations in AD and PA measures, the results have important implications. Findings may facilitate the development of tailored interventions that target women with unique lifestyle recommendations and inspire future research on the specifics of PA type, timing, and duration.


How to Cite: Foster M, McDermott L, Knight A. Physical Activity for the Reduction of Alzheimer’s Disease Risk in Women: A Scoping Literature Review. Women. Health. Bull. 2023;10(2):77-86. doi: 10.30476/WHB.2023.97388.1209.


(1) Alzheimer’s Association. 2021 Alzheimer’s Disease Facts and Figures. Alzheimer’s Dementia. 2021;3(17):327-406. doi: 10.1002/alz.12328. ## (2) Hebert LE, Scherr PA, McCann JJ, Beckett LA, Evans DA. Is the Risk of Developing Alzheimer's Disease Greater for Women than for Men? Am J Epidemiol. 2001;153(2):132–6. doi: 10.1093/aje/153.2.132. PubMed PMID: 11159157. ## (3) Mosconi L. The XX Brain: The groundbreaking science empowering women to maximize cognitive health and prevent Alzheimer’s Disease. New York, NY: Penguin books; 2020. ## (4) Andrew M, Tierney M. The puzzle of sex, gender and Alzheimer’s disease: Why are women more often affected than men? Womens Health. 2018;14:1745506518817995. doi: 10.1177/1745506518817995. PubMed Central PMCID: PMC6311541. ## (5) Lima S, Garrett C, Machado JC, Vilaça M, Pereira MG. Quality of life in patients with mild Alzheimer disease: the mediator role of mindfulness and spirituality. Aging Ment Health. 2020;24(12):2103-2110. doi: 10.1080/13607863.2019.1650891. PubMed PMID: 31411042. ## (6) Wang JH, Wu YJ, Tee BL, Lo RY. Medical Comorbidity in Alzheimer's Disease: A Nested Case-Control Study. J Alzheimers Dis. 2018;63(2):773-781. doi: 10.3233/JAD-170786. PubMed PMID: 29660933. ## (7) Fleming R, Zeisel J, Bennett K. World Alzheimer Report 2020. 2020;1:162-168. (8) Wong W. Economic Burden of Alzheimer's Disease and Managed Care Considerations. Am J Manag Care. 2020;26(8 Suppl):S177–S183. doi: 10.37765/ajmc.2020.88482. PubMed PMID: 32840331. ## (9) WHO. Noncommunicable diseases; 2020. Available from: ## (10) Brini S, Sohrabi HR, Peiffer JJ, Karrasch M, Hämäläinen K, Martins RN, et al. Physical Activity in Preventing Alzheimer’s Disease and Cognitive Decline: A Narrative Review. Sports Med. 2018;48(1):29-44. doi: 10.1007/s40279-017-0787-y. PubMed PMID: 28940148. ## (11) Rosa A, Olaso-Gonzalez G, Arc-Chagnaud C, Millan F, Salvador-Pascual A, Garcia-Lucerga C, et al. Physical exercise in the prevention and treatment of Alzheimer's disease. J Sport Health Sci. 2020;9(5):394–404. doi: 10.1016/j.jshs.2020.01.004. PubMed PMID: 32780691; PubMed Central PMCID: PMC7498620. ## (12) Jia R, Liang J, Xu Y, Wang YQ. Effects of physical activity and exercise on the cognitive function of patients with Alzheimer's disease: a meta-analysis. BMC Geriatr. 2019;19(1):181. doi: 10.1186/s12877-019-1175-2. PubMed PMID: 31266451; PubMed Central PMCID: PMC6604129. ## (13) Stephen R, Hongisto K, Solomon A, Lönnroos E. Physical Activity and Alzheimer’s Disease: A Systematic Review. J Gerontol A Biol Sci Med Sci. 2017;72(6):733–739. doi: 10.1093/gerona/glw251. PubMed PMID: 28049634. ## (14) Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol. 2011;10(9):819–28. doi: 10.1016/S1474-4422(11)70072-2. PubMed PMID: 21775213; PubMed Central PMCID: PMC3647614. ## (15) Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential for primary prevention of Alzheimer's disease: an analysis of population-based data. Lancet Neurol. 2014;13(8):788-94. doi: 10.1016/S1474-4422(14)70136-X. PubMed PMID: 25030513. ## (16) Engeroff T, Ingmann T, Banzer W. Physical activity throughout the adult life span and domain-specific cognitive function in old age: a systematic review of cross-sectional and longitudinal data. Sports Med, 2018;48(6):1405-1436. doi: 10.1007/s40279-018-0920-6. PubMed PMID: 29667159. ## (17) Brasure M, Desai P, Davila H, Nelson V A, Calvert C, Jutkowitz E, et al. Physical Activity Interventions in Preventing Cognitive Decline and Alzheimer-Type Dementia: A Systematic Review. Ann Inter Med. 2018;168(1):30-38. doi: 10.7326/M17-1528. PubMed PMID: 29255839. ## (18) Frederiksen KS, Gjerum L, Waldemar G, Hasselbalch SG. Physical Activity as a Moderator of Alzheimer Pathology: A Systematic Review of Observational Studies. Curr Alzheimer Res. 2019;16(4):362-378. doi: 10.2174/1567205016666190315095151. PubMed PMID: 30873924. ## (19) Hogervorst E, Clifford A, Stock J, Xin X, Bandelow S. Exercise to Prevent Cognitive Decline and Alzheimer’s disease: For Whom, When, What, and (most importantly) How Much? J Alzheimers Dis Parkinsonism. 2012;2(3):e117. doi: 10.4172/2161-0460.1000e117. ## (20) Clifford A, Hogervorst E, Bandelow S. Preventing cognitive decline in the elderly through physical activity in midlife. Alzheimer's & Dementia: The Journal of the Alzheimer's Association. 2011;7(4). doi: 10.1016/j.jalz.2011.05.232. ## (21) Wagner M, Grodstein F, Proust-Lima C, Samieri C. Long-term trajectories of body weight, diet, and physical activity from midlife through late life and subsequent cognitive decline in women. Am J Epidemiol. 2020;189(4):305-313. doi: 10.1093/aje/kwz262. PubMed PMID: 31781745; PubMed Central PMCID: PMC7443200. ## (22) Weuve J, Kang JH, Manson JE, Breteler MMB, Ware JH, Grodstein F. Physical activity, including walking, and cognitive function in older women. JAMA. 2004;292(12):1454-61. doi: 10.1001/jama.292.12.1454. PubMed PMID: 15383516. ## (23) WHO. The top 10 causes of death;2020. Available from: ## (24) Tricco AC, Lillie E, Zarin W, O’Brien K, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467-473. doi: 10.7326/M18-0850. PubMed PMID: 30178033. ## (25) Higgins J P, Thomas J, Chandler J, Cumpston M, Li T, Page M J, Welch V A. Cochrane Handbook for Systematic Reviews of Interventions. Chicago, IL: John Wiley & Sons; 2022. ## (26) WHO. Physical activity; 2020. Available from: ## (27) Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. doi: 10.1186/2046-4053-4-1. PubMed PMID: 25554246; PubMed Central PMCID: PMC4320440. ## (28) NIH. How is Alzheimer’s Disease diagnosed? 2021. Available from: ## (29) Dougherty RJ, Schultz SA, Boots EA, Ellingson LD, Meyer JD, Van Riper S, et al. Relationships between cardiorespiratory fitness, hippocampal volume, and episodic memory in a population at risk for Alzheimer's disease. Brain Behav. 2017;7(3):e00625. doi: 10.1002/brb3.625. PubMed PMID: 28293467; PubMed Central PMCID: PMC5346514. ## (30) Dougherty RJ, Boots EA, Lindheimer JB, Stegner AJ, Van Riper S, Edwards DF, et al. Fitness, independent of physical activity is associated with cerebral blood flow in adults at risk for Alzheimer’s disease. Brain Imaging Behav. 2020;14(4):1154-1163. doi: 10.1007/s11682-019-00068-w. PubMed PMID: 30852709; PubMed Central PMCID: PMC6733668. ## (31) Arntzen KA, Schirmer H, Wilsgaard T, Mathiesen EB. Impact of cardiovascular risk factors on cognitive function: the Tromsø study. Eur J Neurol. 2011;18(5):737-43. doi: 10.1111/j.1468-1331.2010.03263.x. PubMed PMID: 21143340. ## (32) Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K. Physical activity and risk of cognitive impairment and dementia in elderly persons. Arch Neurol. 2001;58(3):498-504. doi: 10.1001/archneur.58.3.498. PubMed PMID: 11255456. ## (33) Varma VR, Chuang YF, Harris GC, Tan EJ, Carlson MC. Low‐intensity daily walking activity is associated with hippocampal volume in older adults. Hippocampus. 2015;25(5):605-15. doi: 10.1002/hipo.22397. PubMed PMID: 25483019; PubMed Central PMCID: PMC4425252. ## (34) Tolppanen AM, Solomon A, Kulmala J, Karehold I, Ngandu T, Rusanen M, et al. Leisure-time physical activity from mid-to late life, body mass index, and risk of dementia. Alzheimer Dement. 2015;11(4):434-443. doi: 10.1016/j.jalz.2014.01.008. PubMed PMID: 24721528. ## (35) Najar J, Ostling S, Gudmundsson P, Sundh V, Johansson L, Kern S, et al. Cognitive and physical activity and dementia: A 44-year longitudinal population study of women. Neurology. 2019;92(12):e1322-e1330. doi: 10.1212/WNL.0000000000007021. PubMed PMID: 30787164; PubMed Central PMCID: PMC6511097. ## (36) Marques A, Peralta M, Sarmento H, Martins J, González Valeiro M. Associations between vigorous physical activity and chronic diseases in older adults: a study in 13 European countries. Eur J Public Health. 2018;28(5):950-955. doi: 10.1093/eurpub/cky086. PubMed PMID: 29767706. ## (37) Rovio S, Kareholt I, Helkala E, Viitanen M, Winblad B, Tuomilehto J, et al. Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease. Lancet Neurol. 2005;4(11):705-11. doi: 10.1016/S1474-4422(05)70198-8. PubMed PMID: 16239176. ## (38) Physical Activity Alliance. National Physical Activity Plan for the United States; 2010. Available from: ## (39) Pray L. Physical activity: Moving toward obesity solutions: Workshop summary. Washington, DC: National Academies Press; 2015. ## (40) Wen LM, Thomas M, Jones H, Orr N, Moreton R, King L, et al. Promoting physical activity in women: evaluation of a 2-year community-based intervention in Sydney, Australia. Health Promot Int. 2002;17(2):127-37. doi: 10.1093/heapro/17.2.127. PubMed PMID: 11986294. ## (41) Public Health England. Everybody Active, Every Day An evidence-based approach to physical activity; 2014. Available from: