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Epidemiological studies have found that more physically active older participants have a reduced risk of Alzheimer disease. Based on enriched environment animal models, this effect is considered to result from physical exercise-induced molecular brain changes. This hypothesis has been tested in humans with randomized controlled trials involving physical exercise vs. more sedentary interventions with neuropsychological outcome measures. Fifty-one such randomized controlled trials were identified from Preferred Reporting Items for Systemat