Your brain is the conductor of your life. It controls movement, stores memories, makes decisions, and forms your identity. This is why declines in brain health, such as during the development of dementia – a broad term for diseases that cause a progressive decline in cognitive function and affects daily living – are so devastating.
Researchers have identified the ε4 allele of apolipoprotein E (APOE) gene – a common genetic variation of a cholesterol-related gene – as a strong genetic risk factor of late on-set dementia. While we cannot change our genes, the good news is genetics aren’t the only thing that drives the risk of dementia. Lifestyle choices, like being physically active and adhering to a healthy diet, also influence the risk of developing dementia.
However, it can be challenging to accurately track and identify these specific healthy habits. Besides, the real importance of healthy habits is that they help maintain overall health. So simpler markers that reflect physical function or overall health may serve as strong predictors of brain health. In our recent study, published in the June 2025 issue of Medicine & Science in Sports & Exercise®, we focused on one such measure: self-reported walking pace. Walking pace reflects more than your speed. It’s a marker of overall physical function and/or health, that can be improved through regular physical activity. Using data from a large-scale study of half a million UK participants whose health was tracked over time, called the UK Biobank, we analyzed how walking pace relates to dementia risk, and whether a faster walking pace might reduce the association of APOE-ε4 status on risk of developing dementia. We also examined the associations of walking pace and APOE-ε4 on brain structural volumes in a subset of more than 33,000 individuals with neuroimaging data.
We found that participants considering themselves slow walkers had an approximately two times greater risk for developing dementia and worse brain structural volume outcomes than those who considered themselves steady average to brisk walkers. While participants with at least one ε4 allele on the APOE gene had an approximately three times greater risk for developing dementia and distinctly worse brain structural volumes than those without the allele. However, for individuals with or without the APOE-ε4 allele, walking at a steady average to brisk pace was associated with a reduced risk of developing dementia.
These results reveal that APOE-ε4 had a greater influence on the risk for developing dementia than being a slow walker, but those who were APOE-ε4 carriers still reduced their risk for dementia if they reported being a steady average to brisk walker.
Certainly, there are some important takeaways from this study for health professionals – from strength trainers and physical therapists to researchers and clinicians. First, since walking pace (self-reported and measured) is an easy variable to measure, it can and should be implemented across disciplines as a marker of overall health and brain health. Next, to maintain health throughout the lifespan, walking pace could be targeted as a modifiable marker of physical function. With the help of health professionals, we may be able to further implement walking pace as a mainstream vital sign for brain health. So, although we cannot out-walk our genes, maintaining a steady average to brisk walking pace throughout the lifespan may be an essential marker of reduced risk of brain health declines.
Daniel H. Aslan, PhD, recently graduated from the University of Southern California, where he studied human biology through an evolutionary lens. His research focuses on the role of cognition during movement and the bidirectional relationship between the brain and body across the lifespan. He plans to continue exploring the connection between human movement and health as a postdoctoral fellow and lecturer in the Skeletal Biology Lab within the Department of Human Evolutionary Biology at Harvard University.
