Exercise is Medicine: the new guide to brain and mental health

Walking, cycling, strength training: the benefits of exercise extend far beyond the muscles and the heart, reaching all the way to the brain. It is from this understanding, supported by a growing body of scientific evidence, that “Exercise is Medicine: A Quick Guide to Prescribing Exercise for Brain and Mental Health” was developed. The guide was presented at Palazzo Marino in Milan as part of Milano4MentalHealth, the initiative through which the City of Milan is placing mental health at the heart of public debate. It is the third volume in the series launched by Wellness Foundation in 2010 to integrate exercise into the prevention and treatment of chronic diseases, and the first to focus entirely on brain health.

The choice of topic responds to a major global health need. Around one in eight people worldwide lives with a mental health disorder and, according to the Global Burden of Disease Study, in 2021 conditions affecting the nervous system were the leading contributor to the global burden of disease, accounting for approximately 11.1 million deaths. Dementia, in particular, is expected to become increasingly prevalent: the estimated 57 million cases in 2019 could rise to 153 million by 2050. Against this backdrop, physical activity is emerging as a tangible resource. Research shows that exercise can reduce symptoms of depression and improve motor and functional abilities in conditions such as stroke, Parkinson’s disease and multiple sclerosis. On the prevention front, an analysis of the Framingham Heart Study published in 2025 in JAMA Network Open found that more physically active people had a 41% lower risk of dementia in midlife and a 45% lower risk in later life. It is no coincidence that the 2024 Lancet Commission includes physical inactivity among the 14 modifiable risk factors for dementia.

The challenge, however, is translating evidence into clinical practice, and this is precisely where the guide aims to make a difference. Designed for neurologists, psychiatrists, general practitioners and exercise professionals, it takes readers from primary prevention through to the management of major neurological conditions, including stroke, Parkinson’s disease, multiple sclerosis, dementia, epilepsy and migraine, as well as conditions such as depression, anxiety, ADHD, and bipolar and psychotic disorders. For each condition, it translates research findings into practical guidance on the type of exercise, frequency, duration, intensity and progression, alongside the goals to set and precautions to consider, helping make exercise a truly personalised prescription tailored to each individual.

The volume was produced under the supervision of the Wellness Foundation Scientific Committee, coordinated by Roberta Balestrino, neurologist at IRCCS Ospedale San Raffaele and President of the Move Your Brain Association, with contributions from Joseph Firth of the University of Manchester and the work of professionals from the Foundation and Technogym. It is supported by the American College of Sports Medicine and the global Exercise is Medicine® initiative.