Background: Although Alzheimer’s disease (AD) is a neurodegenerative pathology characterized
by accumulation of β-amyloid plaques and neurofibrillary tangles at cerebral level, recent studies
highlighted that AD might be the result of many altered physiological processes occurring at
whole-organism level. The ability to adapt to stressors by “bending” but not “breaking” can be considered
as “resilience”. Individuals incline to withstand such pathophysiological challenges, can be considered
more resilient than those that do not. Noticeably, recent literature provide evidence of several
exercise-induced positive effects in AD patients including improved brain plasticity, increased adrenal
sensitivity, increased vascular health, ameliorations of nitric oxide bioavailability and mitochondrial
function. This review explores what resilience means in the AD milieu and the physiological mechanisms
by which physical activity may mediate positive adaptative processes that enhance resilience.
Methods: A comprehensive PubMed search was conducted to identify studies about the role of exercise
in AD resiliency. The following terminology was applied: Alzheimer resilience, brain resilience,
metabolic resilience, cardiovascular resilience, mitochondrial resilience and exercise resilience.
Results: Seventy-three studies were included. Five papers defined Alzheimer’s resilience, 15 papers
brain resilience, 5 cardiovascular resilience, 1 metabolic resilience, 11 mitochondrial resilience, and 7
exercise resilience. Other twenty-six paper were identified from reference list of authors’ knowledge.
Conclusion: Knowing that disturbances in brain, neuroendocrine, vascular and mitochondria metabolism
are important events in neurodegeneration and dementia development, the ability of exercise to
trigger adaptive mechanisms might represent an important non-pharmacological strategy to improve
resilience to AD.