Resisting decline: the neuroprotective role of resistance exercise in supporting cerebrovascular function and brain health in aging

Reduced cerebral blood flow (CBF) and cerebrovascular function are critical early-stage biomarkers preceding changes in brain function and structure observed in normal aging and during the onset and progression of Alzheimer's Disease and related dementias (ADRD). Though several interventions attempt to curb the effects of aging and brain neurodegeneration, exercise and lifestyle habits remain one of the most impactful and easily modifiable factors for preserving brain health. Although the effects of aerobic exercise on cerebrovascular function and brain health are well established, resistance training (RT) is rapidly increasing in popularity across all age demographics due to its numerous health benefits. Despite the clear physiological benefits of resistance exercise, its potential efficacy for preserving or improving cerebrovascular and overall brain health remains understudied to date. The aim of this review is to examine the literature pertaining to ways in which resistance exercise may reduce the risk of ADRD and slow age-related decline of brain structures and functions. Additionally, this review seeks to highlight key considerations and challenges regarding the feasibility, adoption, and adherence to resistance exercise in the context of normal aging, mild cognitive impairment, and ADRD.