Dementia rates are climbing alongside an aging population and Canadians are looking for practical, evidence-based ways to reduce risk.
According to the Lancet Commission on Dementia, nearly 45% of dementia cases could potentially be prevented or delayed by addressing modifiable risk factors, like exercise.
Moderate-to-vigorous physical activity, at almost any dose, is associated with a lower risk of all-cause dementia. The evidence is equally clear in the other direction: a lack of regular exercise meaningfully increases risk. An analysis of 58 studies found that people who exercise regularly may be up to 20% less likely to develop dementia than those who don’t.
Physical activity is one of several modifiable factors people can address to support long-term brain health. Emerging research is adding clarity around how muscle health, creatine, body composition, and gamification tools (that encourage consistent exercise) may complement physical activity as part of a broader approach to dementia prevention, although the evidence in some of these areas is still developing. Other modifiable factors that impact dementia risk include managing blood pressure and blood glucose, quitting smoking, reducing or eliminating alcohol consumption, treating depression, and managing diet. diet.
The most common types of dementia
Dementia isn’t one condition. It’s a collection of distinct conditions, each with its own causes, progression, and risk factors.
Alzheimer’s disease is the most common, accounting for up to 80% of cases in Canada. It typically presents as memory loss, confusion, and a gradual loss of ability to manage daily tasks. Vascular dementia, the second most common type, follows reduced blood flow to the brain, often triggered by stroke or cardiovascular disease. Lewy body dementia brings a different set of challenges: visual hallucinations, disrupted sleep, and motor difficulties that can mirror Parkinson’s disease.
Frontotemporal dementia stands apart from the others. Rather than attacking memory first, it targets behaviour and language. It also tends to appear earlier, often between the ages of 45 and 65, making it the most common form of young-onset dementia.
Why exercise matters for brain health
While each type of dementia carries its own risk factors, exercise offers meaningful protection across the board.
The hippocampus, a key player in memory and learning, naturally shrinks with age, raising the risk of memory decline and neurodegenerative diseases. However, long-term exercise has been shown to slow this atrophy to help protect critical areas responsible for memory, focus, and executive functions.
Clinical studies highlight that regular physical activity also supports cellular health by improving mitochondrial function, boosting oxygen levels, and energy production in the brain which lowers risk and protects cognitive health.
Alzheimer’s & Vascular Dementia
Regular physical activity is linked to a 21% – 39% lower risk of developing Alzheimer’s and measurable increases in hippocampal volume, the brain’s memory centre. The case for vascular dementia is even more direct, because exercise targets the cardiovascular risk factors that cause vascular brain injury in the first place.
Lewy Body Dementia
For Lewy body dementia, research does not yet point to specific protective mechanisms. However, the general brain health benefits of regular physical activity, such as better circulation, reduced inflammation and improved sleep quality, may help improve overall health and reduce fall risk given the disease profile.
Frontotemporal Dementia
For those carrying a genetic predisposition for frontotemporal dementia, the evidence is striking. Carriers who maintained higher levels of physical and cognitive activity experienced more than 55% slower clinical decline per year. Activity doesn’t stop the disease, but it appears to build enough resilience to meaningfully delay its impact.
Practical steps to build resilience
How creatine supports brain health
Creatine has a well-established record in muscle performance and athletic recovery, but newer research points to its role in how the brain manages energy.
The brain accounts for only 2% of body weight but consumes roughly 20% of the body’s total energy. Most creatine lives in muscle tissue, but the small amount stored in the brain plays a direct role in rapidly replenishing cellular energy. Research consistently shows that creatine’s cognitive benefits are most pronounced under stress including sleep deprivation, hypoxia, or intense mental fatigue. In young, rested adults with sufficient baseline energy, supplementation tends to show little measurable change.
Systematic reviews consistently show that older adults see the most reliable cognitive benefits from creatine. As brain bioenergetics naturally decline with age, an external energy source helps older adults sustain the cognitive reserves that demanding tasks require.
Please consult your Harrison care team before adding any supplement to your diet. They can confirm the appropriate amount for your needs and ensure it won’t interact with any medications or supplements you’re already taking.
Making exercise stick through gamification
Exercise adherence, not intensity, is what drives long-term brain health benefits. A demanding routine abandoned after six weeks does less for cognitive function than a moderate one maintained indefinitely. For many, the barrier to exercise is motivation and one well studied solution is to gamify it.
Gamified fitness strategies layer novelty, progress tracking, and social structure onto physical activity, giving the brain a reason to stay engaged beyond sheer willpower. The brain responds to new stimuli, and varied, game-like challenges keep exercise from becoming something to endure.
Zwift is a popular example of gamification built primarily for cycling and running. It places users inside a virtual world where they ride or run alongside other real participants, complete structured challenges, and earn tangible progress.
Smartwatches are another gamified option, letting users track personal progress, compete against their own past performance, or maintain streaks.
Additional examples of gamification include Strava, Zombies, Run!, Pokémon Go, group exercise, sports and movement-based activity classes.
Exercise only protects cognitive function if it actually happens, so tools that make consistency easier are part of a successful strategy.
How thigh circumference connects to cognitive resilience
A surprising predictor of cognitive decline has emerged that is tied directly to physical fitness and more specifically, thigh circumference. A large-scale study published in the Journal of Epidemiology & Community Health found that older adults with greater thigh muscle mass showed a lower prevalence of cognitive decline.
The science behind this is straightforward. Thigh circumference reflects overall skeletal muscle mass, which regulates glucose, reduces inflammation, and produces myokines, proteins that cross the blood-brain barrier and support the growth of new brain cells. Less muscle means fewer of those protective signals reaching the brain over time.
This emphasizes the importance of strength training for a complete brain-health strategy. Research comparing aerobic training with resistance training consistently shows that strength work contributes distinct cognitive benefits, particularly in executive function and memory, that aerobic exercise doesn’t fully replicate. Building and preserving muscle, especially in the lower body, gives the brain a longer-term metabolic advantage.
Preventing dementia through movement and proactive care
A few consistent additions to your routine can support both body and brain, reducing dementia risk over time. Movement, done regularly and with intention, is one of the more reliable ways to protect cognitive clarity as you age.
The right starting point is a plan built around your needs, your timeline, your personal health profile and your goals. At Harrison, our team can help you build a prevention strategy that fits your life. Reach out today to take that first step toward better brain health.
