Cycling Tied to 19% Lower Risk of Dementia: Daily Dose

_{©New Africa/AdobeStock}

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On June 12, 2025, we reported on a study published in JAMA Network Open that was designed to examine how different ways of getting around relate to dementia risk and brain health.

The study

For the prospective cohort study, investigators categorized participants into 4 travel groups based on their most frequent non-work transportation in the preceding 4 weeks: nonactive (car, motor vehicle, or public transport), walking only, mixed-walking (combination of nonactive and walking), and cycling with mixed-cycling. The research team identified dementia cases through hospital records and death registries. Cox proportional hazards regression models were adjusted for demographic factors, socioeconomic status, lifestyle variables, comorbidities, cognitive function, and genetic variables.

The study included 479 723 participants, with 271 690 individuals in the Young-Onset Dementia (YOD) analysis and 334 939 in the Late-Onset Dementia (LOD) analysis. The median follow-up was 13.1 years and identified 8845 incident dementia cases.

The findings

Compared to nonactive travel modes, multivariable-adjusted hazard ratios (HRs) for cycling and mixed-cycling were 0.81 (95% CI, 0.73–0.91) for all-cause dementia, 0.78 (95% CI, 0.66–0.92) for AD, 0.60 (95% CI, 0.38–0.95) for YOD, and 0.83 (95% CI, 0.75–0.93) for LOD.

A significant interaction between travel mode and genetic susceptibility was observed for all-cause dementia (P = .02) and LOD (P = .04), indicating that the association was modified by APoE ε4 carrier status. Specifically, in the cycling and mixed-cycling groups, the risk of all-cause dementia and LOD was lower among individuals without APOE ε4 (all-cause dementia: HR, 0.74 [95% CI, 0.63–0.87]; LOD: HR, 0.75 [95% CI, 0.63–0.89]) compared to those with APOE ε4 (all-cause dementia: HR, 0.88 [95% CI, 0.76–1.02]; LOD: HR, 0.91 [95% CI, 0.78–1.05]).

Additional findings suggested protective effects of mixed-walking modes (combination of nonactive and walking), which reduced all-cause dementia risk by 6% (HR 0.94, 95% CI 0.89-0.98). However, walking alone showed no significant protection against all-cause dementia and actually correlated with a 14% increased AD risk (HR 1.14, 95% CI 1.01-1.29), while cycling maintained its protective effect against AD with a 22% risk reduction (HR 0.78, 95% CI 0.66-0.92).

Authors' comments

"Our findings suggest that promoting active travel strategies, particularly cycling, may be associated with lower dementia risk among middle-aged and older adults, which carries substantial public health benefits by encouraging accessible, sustainable practices for cognitive health preservation."

Click here for more details.