Walking to Brain Health: Small 1-Year Study Links Aerobic Walking Program to Slower Brain Aging in MS

# What the study did Researchers tested whether a year-long, remotely delivered aerobic walking exercise training (ET) affects brain aging in people with multiple sclerosis (MS). They enrolled 24 fully ambulatory participants who underwent 3T MRI before and after the 1-year programme. Brain age was calculated using brain-ageR (v2.1), a model that compares a participant's brain morphology to a large, age-diverse training set and yields a brain-age metric.

# What they found Over one year of aerobic walking ET the group showed an average increase in brain age of 0.74 years. The authors compared this against a published annualized rate of accelerated brain aging in relapsing-remitting MS (RRMS), which was 1.24 years per year. Because 83% of the study participants had RRMS, the study framed the 0.74-year change as corresponding to a 0.50-year slowing of brain aging relative to that published RRMS rate.

# Why this matters Brain atrophy or "brain aging" is an important structural marker in MS. If a low-cost, remotely delivered walking programme can slow MRI-derived brain aging, it would be a feasible, scalable intervention to test further. The result also aligns with general evidence that aerobic activity benefits brain and overall health.

# Important limitations

• Small sample size: only 24 participants limits statistical power and generalisability. Results should be considered preliminary.
• Lack of a contemporaneous control group: the comparison is against a published reference rate for RRMS rather than against a randomized control arm in the same study.

# Practical takeaways for people with MS

• Regular aerobic walking may be associated with slower MRI-measured brain aging, at least in fully ambulatory people with MS.
• Remote delivery of a walking programme is feasible and could increase access for people who cannot attend in-person classes.

# Next steps the authors propose The authors suggest designing and testing a larger, longer-term trial of remotely delivered and supported aerobic walking ET that uses brain age as a primary, clinically relevant outcome and examines downstream consequences such as cognitive or functional benefits.

# Bottom line