A new study from McGill University’s Montreal Neurological Institute-Hospital (The Neuro) suggests that the decision to stay active after a cardiovascular diagnosis may be shaped as much by social and environmental factors as by brain biology.
Researchers found that older adults who maintained or increased physical activity following a diagnosis of heart disease or diabetes were more likely to have strong social connections, access to parks and greenspace, and distinct patterns of brain connectivity that support motivation and self-regulation.
The findings, published this week in the Proceedings of the National Academy of Sciences of the United States of America (PNAS), offer new insight into how lifestyle changes occur in the wake of major health events—and how doctors might better support those changes in the future.
Study Overview
The research team at The Neuro analyzed data from 295 adults over the age of 60 from the UK Biobank who had been diagnosed with cardiovascular or circulatory conditions. Using a combination of brain imaging, machine learning, and health and social background questionnaires, the scientists investigated why some people become more physically active after diagnosis while others do not.
Their analysis revealed that long-term increases in exercise were associated with both environmental and social supports. “People who increased their physical activity levels long-term after diagnosis tended to have greater access to greenspace and social support than those who got less exercise, factors that make it easier to sustain healthy habits,” the researchers reported.
Brain Connections and Cognitive Benefits
In addition to external factors, brain imaging data revealed significant neurological differences between participants who exercised more and those who remained sedentary. Individuals who showed stronger connectivity between the right superior frontal gyrus and two other brain regions—the ventromedial prefrontal cortex and the precuneus—were more likely to be physically active.
The researchers also noted that exercise had measurable effects on cognitive function. Those who engaged in more physical activity performed better on tests measuring working memory, executive function, and problem-solving skills.
“Our results show that while people with a cardiovascular diagnosis benefit neurologically from physical activity, factors from an individual’s context influence whether they actually engage in meaningful change,” says Dr. Maiya Geddes, a clinician-researcher at The Neuro and the paper’s senior author. “Social determinants and brain wiring play a role. In future, novel brain markers may help doctors determine people’s willingness to change exercise habits, and brain circuits might be targeted with neurostimulation or other strategies to encourage behaviour change.”
Her co-author, Naga Thovinakere, a PhD candidate at The Neuro and the study’s first author, emphasized the broader implications for public health. “The more we know about factors that influence positive behaviour change, the better we can help patients move to healthier lifestyles,” he said.
Implications for Health Policy and Practice
The study’s conclusions come at a time when Canadian health agencies are increasingly focused on improving quality of life for aging populations and reducing the long-term burden of chronic disease. Cardiovascular conditions remain a leading cause of death in Canada, accounting for nearly one in five deaths nationwide, according to Health Canada.
By identifying both social and neurological predictors of exercise adherence, the research could inform targeted interventions—pairing clinical treatments with programs that enhance social support or improve access to outdoor spaces. Experts say such strategies could help bridge the gap between awareness and action, translating diagnosis into sustained lifestyle change.
The project was funded through the Canada Brain Research Fund (CBRF), a partnership between the Government of Canada (via Health Canada) and the Brain Canada Foundation, in collaboration with the Canadian Institutes of Health Research (CIHR). Additional support came from a Brain Canada Future Leaders Award.
About The Neuro
Founded in 1934 by pioneering neurosurgeon Dr. Wilder Penfield, The Neuro – formally the Montreal Neurological Institute-Hospital – has grown into Canada’s largest specialized neuroscience research and clinical centre and one of the largest worldwide. A research and teaching institute of McGill University and part of the McGill University Health Centre’s Neuroscience Mission, The Neuro is known globally for its bilingual clinical care, integration of research and treatment, and early adoption of Open Science principles to accelerate brain research.
More information about The Neuro and its ongoing research can be found at www.theneuro.ca.
