Trends and Hotspots in Research on Exercise and Alzheimer's Disease: A Decade of Bibliometric Review on Prevention and Molecular Mechanisms.

With the rapid acceleration of global aging, the prevalence of Alzheimer's disease (AD) continues to rise, exerting a profound impact on elderly individuals' physical health, lifestyle, and quality of life. Exercise has demonstrated significant research value and broad application potential in AD as a non-pharmacological preventive and therapeutic approach. This study aims to provide a bibliometric and visual analysis of research related to exercise and AD over the past decade. It seeks to identify research hotspots and development trends, explore the layers of research on exercise's impact on AD, and clarify its preventive effects and molecular mechanisms. The Web of Science Core Collection database was used as the data source for this study. A comprehensive search was conducted using the topic "exercise for Alzheimer's disease," covering the period from January 1, 2014, to August 31, 2024. CiteSpace and Python were employed to perform bibliometric and visual analyses on these publications, including assessments of publication trends, keyword co-occurrence, clustering analysis, timeline analysis, burst detection analysis, and the distribution and growth trends of molecular mechanisms related to exercise and AD. 1. Annual publication trends: 6134 articles were included in the analysis. The number of publications on exercise and AD increased steadily from 2014 to 2024 ( = 53.23, < .001). 2. Keyword co-occurrence and clustering analysis: research on exercise and AD primarily focuses on themes related to cognitive decline, risk factors, exercise-induced energy metabolism, exercise intensity, and molecular mechanisms. 3. Keyword timeline and burst analysis: epidemiological and clinical studies maintained high activity levels in the early and mid-stages of the research timeline, whereas molecular-level studies exhibited increased activity in the later stages. 4. Molecular mechanisms distribution: analysis of molecular mechanisms reveals that amyloid-beta deposition and oxidative stress remain the predominant research areas. Meanwhile, research on neuroinflammation, brain-derived neurotrophic factor (BDNF), Tau pathology, and other related mechanisms has been further explored. The findings demonstrate a progressive shift in research focus from general epidemiological patterns to more in-depth investigations of molecular biological mechanisms. Exercise has been shown to play a preventive role at the clinical level by improving cognitive function and mitigating risk factors and at the molecular level by modulating key pathological mechanisms, including β-amyloid deposition, oxidative stress, BDNF, tau pathology, and others. Through the coordinated regulation of multiple targets and pathways, exercise exerts a neuroprotective effect against AD.