This review synthesizes animal and human evidence on how exercise modulates glymphatic system function — a perivascular brain network that clears neurotoxic waste products — and examines its vulnerability to aging and neurodegeneration.
The authors propose that known regulators of glymphatic function (e.g., sleep, arterial pulsatility, AQP4 water channels) overlap with physiological adaptations to exercise, providing a mechanistic framework linking physical activity to glymphatic integrity and brain resilience.
As a narrative review, it does not provide pooled effect sizes or systematic quality assessment of included studies; much of the mechanistic evidence is drawn from animal models, limiting direct translation to humans.
Exercise may support brain waste clearance via the glymphatic system, offering a plausible neuroprotective mechanism relevant to aging and neurodegenerative disease prevention. Clinicians can reinforce exercise recommendations as part of brain health strategies while awaiting human mechanistic trials.
