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December 7, 2025Open Access

Effects of 5-Year Exercise Training on Cognition in Older Adults: 10-Years Follow-Up from the Generation 100 Study

DBDaniel Estil BrissachNorwegian University of Science and Technology EIEmma M. L. IngeströmNorwegian University of Science and Technology TWTara L. WalkerThe University of Queensland

Key Points

Exercise training over 5 years showed limited impact on cognitive function in older adults, despite adherence to interventions.
Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) score over a 10-year period.
Participants were assigned to high-intensity interval training or moderate-intensity continuous training interventions.
Findings highlight the need for further long-term studies to understand exercise's effects on cognition.

Abstract

Abstract Background and aim The rapid aging of the global population is expected to lead to an increase in the incidence and prevalence of neurodegenerative diseases. Endurance exercise training is considered one of the most effective forms of prevention against neurodegenerative diseases. This study investigated the effects of a 5-year exercise training intervention at varying intensities on cognitive function in healthy older adults. Methods 1486 healthy older men ( n = 735) and women ( n = 751) aged 70–77 years from Trondheim, Norway, were randomly assigned to high-intensity interval training (HIIT, n = 382), moderate-intensity continuous training (MICT, n = 367), or a control group ( n = 737) following the national physical activity (PA) guidelines. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) score after 3, 5 and 10 years. A linear mixed model was used to estimate the effect of the exercise intervention between the groups. Measures of physical health, such as cardiorespiratory fitness (CRF), and PA level was also measured. Results After 10 years, we observed no significant differences in MoCA scores between the exercise training groups and the control group, despite variations in exercise intensity and good adherence to the exercise interventions. The HIIT group consistently showed higher CRF throughout the study period. Conclusions While structured aerobic exercise training over 5 years improved physiological health markers in healthy older adults, its impact on mitigating cognitive decline was limited. Further long-term training studies in different populations are needed to better understand the link between exercise training and cognition in older adults. Trial Registration The Generation 100 Study is registered at ClinicalTrials.gov (Identifier: NCT01666340), registered on 21 August 2012: https://clinicaltrials.gov/study/NCT01666340

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