A new study offers encouraging evidence that even small increases in daily activity could help slow cognitive decline, particularly in individuals at risk for Alzheimer’s disease. The findings suggest that consistent, modest increases in daily steps can have a meaningful impact on brain health, although further clinical trials are needed to confirm these initial observations.
How Many Steps Are Needed for Brain Protection?
Researchers analyzed health data from approximately 300 adults aged 50 to 90, all of whom exhibited early signs of biological markers associated with Alzheimer’s disease. Initial measurements, taken over four to seven days, used pedometers to track daily step count, and crucially, none of the participants showed any signs of cognitive impairment at the study’s outset.
The study followed participants for up to 14 years, periodically administering cognitive tests and utilizing brain imaging to monitor the buildup of beta-amyloid and tau proteins—proteins linked to Alzheimer’s disease progression.
The study revealed that individuals who began with high levels of beta-amyloid experienced less cognitive decline when they were more physically active. Specifically, those engaging in low or moderate activity had a reduced risk of cognitive decline—up to 54 percent lower—compared to inactive participants.
Here’s a breakdown of the findings:
- 3,000 to 5,000 steps: Associated with a three-year delay in cognitive decline.
- 5,000 to 7,500 steps: Linked to an average delay of seven years in cognitive decline.
- More than 7,500 steps: Did not appear to offer any additional benefit in slowing cognitive decline.
Sedentary individuals—those taking less than 3,000 steps a day—experienced a faster buildup of tau proteins in the brain and quicker declines in cognition and daily functioning.
“Notably, even modest activity levels—compared to sedentary individuals—were associated with slower tau accumulation and cognitive decline. The most significant gains were seen at moderate activity levels, like 5,001 to 7,500 steps per day or more,” says Dr. Wai-Ying Wendy Yau, the study’s lead author. She emphasizes that these results align with previous research.
Connecting Exercise and Changes in the Brain
Researchers have established that individuals at risk for Alzheimer’s disease often exhibit elevated levels of amyloid-beta and tau proteins in the brain. Previous research has pointed to the potential benefits of increased physical activity in cognitively normal people with elevated amyloid levels, suggesting a link to slower cognitive decline. However, the connection between physical activity and changes in amyloid or tau proteins over time has remained unclear.
This latest study clarifies that the benefits of physical activity related to slowed cognitive decline are not primarily due to differences in amyloid buildup, but rather to slower rates of tau protein buildup.
“Higher step counts were associated with slower accumulation of tau, the protein most closely tied to cognitive symptoms – which largely accounted for the association with slower cognitive decline,” explains Dr. Yau.
Small Changes Can Make a Difference
While the findings aren’t entirely surprising given existing connections between physical activity and overall health, they highlight the potential for an achievable physical activity goal, particularly for those who are less active.
“What impressed me most is the dose-response,” says Martin Burtscher, a professor of sports science. “Cognitive decline hit a plateau at a moderate level of physical activity, or 5,001–7,500 steps per day. This is a relatively easy daily amount of physical activity to achieve.”
Dr. Burtscher suggests incorporating occasional periods of higher-intensity walking, alongside strength and coordination training. For long-term health, he notes that consistently higher daily activity levels—potentially exceeding 10,000 steps—may be required for cancer prevention.
What’s Next?
Researchers are planning further clinical trials to definitively confirm that walking is responsible for the slowed rate of cognitive decline, rather than other behavioral factors. Future research will also focus on better understanding the specific aspects of physical activity—such as duration, intensity, and daily patterns—that best support long-term brain health.
Dr. Yau encourages individuals to make small, sustainable changes to increase their physical activity as a potential strategy to improve brain health.
“For people who are currently sedentary, every additional step counts,” she says. “Setting modest goals, like standing during TV commercials, parking farther away, or taking a walk with a friend, can help increase activity in simple, sustainable ways.”
SOURCES
- Yau WYW et al. Physical Activity as a Modifiable Risk Factor in Preclinical Alzheimer’s Disease. Nature Medicine. November 2025.
- Lee I-M et al. Association of Step Volume and Intensity With All-Cause Mortality in Older Women. JAMA Internal Medicine. August 2019.
- What Happens to the Brain in Alzheimer’s Disease? National Institute on Aging. January 2024.
- Farrell ME et al. Association of Emerging β-Amyloid and Tau Pathology With Early Cognitive Changes in Clinically Normal Older Adults. Neurology. April 2022.
- Benefits of Physical Activity. Centers for Disease Control and Prevention. April 2024.
- Ding D et al. Daily Steps and Health Outcomes in Adults: A Systemic Review and Dose-Respondent Meta-Analysis. The Lancet. August 2025.
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