Global study links cardiorespiratory fitness to reduced mental health disorder risk

A major global review suggests that higher levels of cardiorespiratory fitness may significantly reduce the risk of several serious mental and neurocognitive disorders, including dementia, depression and psychosis.

The findings, published in Nature Mental Health, are based on a large meta-analysis led by researchers from the University of Castilla-La Mancha and the Karolinska Institutet.

Cardiorespiratory fitness refers to the body’s ability to supply oxygen efficiently during sustained physical activity, reflecting the health of the heart and lungs.

The research team reviewed data from 27 long-term cohort studies involving more than 4 million participants across multiple age groups. All participants were initially free of diagnosed mental or neurocognitive disorders.

The analysis found that individuals with higher fitness levels had a 39% lower risk of dementia, a 36% lower risk of depression, and a 29% lower risk of psychotic disorders compared to those with lower fitness levels.

Even modest improvements in fitness were linked to measurable benefits. For example, a small increase in fitness capacity was associated with a 5% lower risk of depression and a 19% lower risk of dementia.

Researchers also noted a 10% reduction in anxiety risk, although this finding did not reach statistical significance.

Lead researcher Dr. Bruno Bizzozero Peroni said the results highlight cardiorespiratory fitness as a “modifiable and scalable” factor that could play an important role in mental health prevention strategies.

Unlike physical activity alone, cardiorespiratory fitness provides a more objective measure of how effectively the body uses oxygen during exercise, offering a clearer indicator of overall health resilience.

The researchers say the findings support the idea that even small, consistent improvements in fitness, rather than elite athletic performance, may help reduce long-term mental health risks at a population level.

The study also highlights gaps in current research, noting that most existing data comes from middle-aged adults in Europe and North America, with fewer studies in children, adolescents, and older populations.

Scientists involved in the review say future research should explore biological mechanisms such as neuroplasticity, inflammation, and stress regulation to better understand how fitness influences brain health.