Older adults frequently experience cognitive deficits accompanied by deterioration of brain tissue and function in a number of cortical and subcortical regions. Because of this common finding and the increasing aging population in many countries throughout the world, there is an increasing interest in assessing the possibility that partaking in or changing certain lifestyles could prevent or reverse cognitive and neural decay in older adults. In this review we critically evaluate and summarize the cross-sectional and longitudinal studies that assess the impact of aerobic exercise and fitness on cognitive performance, brain volume, and brain function in older adults with and without dementia. We argue that six-months of moderate levels of aerobic activity are sufficient to produce significant improvements in cognitive function with the most dramatic effects occurring on measures of executive control. These improvements are accompanied by altered brain activity measures and increases in prefrontal and temporal grey matter volume that translate into a more efficient and effective neural system.
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