With increasing age, muscle mass steadily decreases, which also reduces muscle strength. The muscle fibers become thinner and fewer and the connections between the nerves and muscles are also broken down.
Numerous studies now show that the loss of muscle mass and strength not only has physical consequences such as an increased risk of falling, frailty or loss of independence, but is also associated with a decline in cognitive performance and an increased risk of dementia. Against this backdrop, strength training is increasingly being discussed as a promising non-pharmacological intervention – both for the prevention and monitoring of neurodegenerative diseases such as mild cognitive impairment (MCI) and Alzheimer’s disease.
What is strength training?
Strength training describes a form of training in which the muscles have to work against resistance in order to build muscle mass, increase muscle strength or improve muscular endurance [9].
What does strength training do to the brain?
Results from animal and human studies suggest that strength training influences the brain via several biological processes, some of which have not yet been fully decoded. In research, these mechanisms of action are often described in isolation, but in the human body they interact and develop their effect as a dynamic interplay.
Brain structures
The posterior cingulum is a structure of the limbic system that is closely connected to important brain regions such as the hippocampus region and loses volume particularly early in Alzheimer’s disease. Strength training can help to maintain or even build up the structure and thickness of the posterior cingulum, slowing down neuronal degeneration. Strength training also protects the white matter, i.e. the nerve pathways that transmit information between brain regions, from degeneration [10].
Muscle-brain communication with messenger substances
During strength training, the muscles release hormones and messenger substances.
An important messenger substance that is produced by the muscles is IGF1 (insulin-like growth factor 1) . IGF1 enters the brain via the blood-brain barrier, together with other training signals. There it stimulates the production of growth factors such as BDNF (Brain-Derived Neurotrophic Factor) and VEGF (Vascular Endothelial Growth Factor) . These in turn support communication between nerve cells, promote the growth of nerve processes and the formation of new synapses and can thus improve learning and memory processes [8,5,3].
In addition, during strength training myokines are released, such as irisin and cathepsin B. They also cross the blood-brain barrier and increase the release of BDNF in the brain. This promotes neuronal plasticity in the hippocampus – an area that plays a central role in learning, memory and protection against Alzheimer’s disease [8].
Neuroinflammation
The immune system’s performance decreases with increasing age. As a result, more pro-inflammatory messenger substances, so-called cytokines (e.g. IL-1, IL-6, TNF-α), are released, which leads to chronic, low-grade inflammation throughout the body. These “silent” inflammatory processes also take place in the brain (neuroinflammation). Inflammation in the brain disrupts nerve cells during signal transmission, reduces BDFN expression and decreases the formation of new nerve cells. Regular strength training can have a positive influence on this process by reducing pro-inflammatory factors and simultaneously increasing anti-inflammatory substances. As a result, the brain and nerve cells are better protected and supported [1,9].
Insulin metabolism
In old age, muscle loss, increased body fat and lack of exercise promote the disease-causing process of insulin resistance, which can disrupt glucose utilization in the body and brain. This is associated with reduced degradation of amyloid-β (Aß) proteins and increased formation of tau fibrils. Both are components of the deposits in the brain that are typical of Alzheimer’s disease. Their formation is considered a central mechanism in the development of the disease. Strength training can counteract this development by reducing insulin resistance and thus supporting insulin action in the brain [9].
Amyloid-ß plaques and tau pathology
Animal studies show that strength training increases the clearance of Aβ deposits, reduces Aβ production through changes in enzyme-dependent processes and altered transport mechanisms, and thus reduces both the amount and volume of Aβ plaques. At the same time, tau pathology in the brain is attenuated [8].
Many of these mechanisms have so far mainly been proven in animal studies. In order to verify their transferability to humans, a better understanding of the underlying biological processes and further high-quality clinical studies are required.
The effect of strength training in Alzheimer’s patients
MCI (Mild Cognitive Impairment)
Mild Cognitive Impairment (MCI) is a cognitive disorder in which memory, attention or language are impaired, while everyday abilities are largely preserved. Between 6% and 10% of people with MCI develop dementia.
A systematic review of people over the age of 50 with MCI showed that strength training can significantly improve thinking ability (ADAS-Cog: -23.3%). Memory and attention also benefited from the training (DST-B: +12.0 %), indicating that affected patients were better able to retain and process information in the short term [2].
In people aged 60 and over, a network meta-analysis of 18 randomized trials shows that strength training significantly improves global cognition, executive functions (e.g. planning, organizing, adapting) and memory (taking in, storing and retrieving information) in MCI. Combination programs that combine strength and endurance training were even more effective than strength training alone [6].
A further meta-analysis with participants over 60 years of age and MCI showed in 12 studies that strength training significantly improves executive functions as well as attention and memory [7].
Dementia
The above-mentioned network meta-analysis also shows that strength training also has positive effects in patients with Alzheimer’s dementia: both global cognition and executive functions and memory performance improved significantly [6].
A more recent meta-analysis came to similar conclusions: Strength training showed a positive effect on both global cognition and everyday functions. The authors also conclude that strength training in combination with reminiscence and music therapy is beneficial to the overall health of people with dementia [4].
Conclusion
Strength training not only strengthens our muscles, but also our brain. Although the exact mechanisms are not yet fully explained and further clinical studies are pending, there are numerous scientific hypotheses that describe how strength training can positively influence our cognitive function. In particular, results from human studies indicate that regular strength training can have a preventive effect in MCI. There is also initial clinical evidence for Alzheimer’s disease.
This means for everyday life:
Train strength regularly, ideally 2-3 times a week. You should perform 3-5 sets of 6-15 repetitions per exercise with at least 1-3 minutes rest in between. The resistance should be selected so that the last repetition is only possible with difficulty – i.e. around 70-92% of the weight that you can manage cleanly once. Dumbbells, resistance bands or free weights are suitable training equipment.
You can find more information on training for dementia here.
References
- Ayari, S., Abellard, A., Carayol, M., Guedj, É., & Gavarry, O. (2023). A systematic review of exercise modalities that reduce pro-inflammatory cytokines in humans and animals’ models with mild cognitive impairment or dementia. Experimental Gerontology, 175, 112141. https://doi.org/10.1016/j.exger.2023.112141
- Castro, K., Bamdas, J. A. M., Ortega, M. D., Jacomino, M., Castro, K., Bamdas, J. A. M., Hernández, M. de los Á. D. O., & Jacomino, M. (2025). Identifying Exercise Interventions That May Slow the Progression of Cognitive Decline in Older Adults With Mild Cognitive Impairment: A Scoping Review. Cureus, 17(3). https://doi.org/10.7759/cureus.80895
- Cefis, M., Chaney, R., Wirtz, J., Méloux, A., Quirié, A., Leger, C., Prigent-Tessier, A., & Garnier, P. (2023). Molecular mechanisms underlying physical exercise-induced brain BDNF overproduction. Frontiers in Molecular Neuroscience, 16, 1275924. https://doi.org/10.3389/fnmol.2023.1275924
- Chang, Y.-H., Huang, S.-F., Yang, H.-R., & Liao, J.-Y. (2025). Health Impacts of Nonpharmacologic Interventions Among People Living With Dementia: A Systematic Review and Network Meta-Analysis. Dementia, 14713012251367079. https://doi.org/10.1177/14713012251367079
- Herold, F., Törpel, A., Schega, L., & Müller, N. G. (2019). Functional and/or structural brain changes in response to resistance exercises and resistance training lead to cognitive improvements – a systematic review. European Review of Aging and Physical Activity, 16(1), 10. https://doi.org/10.1186/s11556-019-0217-2
- Huang, X., Zhao, X., Li, B., Cai, Y., Zhang, S., Wan, Q., & Yu, F. (2022). Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia: A systematic review and network meta-analysis. Journal of Sport and Health Science, 11(2), 212-223. https://doi.org/10.1016/j.jshs.2021.05.003
- Li, H., Su, W., Dang, H., Han, K., Lu, H., Yue, S., & Zhang, H. (2022). Exercise Training for Mild Cognitive Impairment Adults Older Than 60: A Systematic Review and Meta-Analysis. Journal of Alzheimer’s Disease, 88(4), 1263-1278. https://doi.org/10.3233/JAD-220243
- Li, W., Fang, W., Zhang, Y., Chen, Q., Shentu, W., Lai, Q., Cheng, L., Yan, S., Kong, Q., & Qiao, S. (2025). Research progress on resistance exercise therapy for improving cognitive function in patients with AD and muscle atrophy. Frontiers in Aging Neuroscience, 17, 1552905. https://doi.org/10.3389/fnagi.2025.1552905
- Oudbier, S. J., Goh, J., Looijaard, S. M. L. M., Reijnierse, E. M., Meskers, C. G. M., & Maier, A. B. (2022). Pathophysiological Mechanisms Explaining the Association Between Low Skeletal Muscle Mass and Cognitive Function. The Journals of Gerontology: Series A, 77(10), 1959-1968. https://doi.org/10.1093/gerona/glac121
- Suo, C., Singh, M. F., Gates, N., Wen, W., Sachdev, P., Brodaty, H., Saigal, N., Wilson, G. C., Meiklejohn, J., Singh, N., Baune, B. T., Baker, M., Foroughi, N., Wang, Y., Mavros, Y., Lampit, A., Leung, I., & Valenzuela, M. J. (2016). Therapeutically relevant structural and functional mechanisms triggered by physical and cognitive exercise. Molecular Psychiatry, 21(11), 1633-1642. https://doi.org/10.1038/mp.2016.19
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