Feter N, Iso-Markku P, Markarian T, et al. Lancet Public Health. 2026;11(9):e650-e664.
International
Higher physical activity was associated with lower all-cause dementia risk (RR 0.80), Alzheimer disease (0.79) and vascular dementia (0.71). Leisure-time activity was protective (RR 0.76), while occupational (1.20) and commuting activity (1.10) showed higher risk. Certainty across domains was very low to low and heterogeneity was high.
Observational evidence, extreme heterogeneity, domain measurement inconsistency, residual confounding and healthy-worker effects; certainty rated very low to low.
74 longitudinal studies; 4,227,297 adults; median age 67.3 years
Physical activity remains associated with lower dementia risk, but this review adds an important systems message: context matters. Leisure-time activity appears protective, while occupational activity may carry different exposures and inequalities. Avoid reducing 'move more' to a simple dose-only message.