Takeaway
Regular bike riding reduces stress and lowers dementia risk. Do it daily and routinely ask patients, “What does your typical daily movement look like?”
Lifelong Learning in Clinical Excellence | October 8, 2025 | 3 min read
By Chris Tiplady, MD, Northumbria Healthcare, England
Why I cycle home from work
I commute to work every day by bicycle and one of the many reasons I cycle is the ride home from work where I can forget the day, move on, disengage, wrap up, and process. I’ve known for a long time that this cycling habit reduces my risk of cancer, cardiovascular disease, and all-cause mortality (read about that here). Little did I know my commuting behavior has now also been shown to reduce my risk of dementia too. This paper looked at the travel habits of nearly half a million people with a median age of exactly my own (56.5yrs). Compared with non-active travel (car or bus) cycling was the most significant form of transport to modify the risk of developing dementia, especially at a young age (and quite substantially too).
A surprising link
This new information was a real surprise. It got the doctor in me wondering how on earth this could be and the cyclist in me screaming “Do you really need another reason to be more active?!” Dementia is a real worry for me and many others, as well for society. Dementia rates are rising, and the cost of patient care is going to be enormous. We need to be doing everything we can to modify our own risk and influence others.
“Attenuation of stress response”
But how on earth is there a relationship between cycling and dementia? The paper discusses a few thoughts about brain structure and neurochemical stuff. All perfectly logical. The other bit that made sense to me was when it discussed “attenuation of stress response,” engagement of the brain, better blood perfusion, and cognitive demand. This is exactly what cycling feels like to me. It engages my mind completely for 40 minutes twice a day. I get my heart rate up, I sweat a bit, I look ahead to plan a safe route, to keep away from the bumpy bits or the puddles. I get a chance to wind down from the day, to think through a few things, so by the time I’m home I’ve usually forgotten them. It’s most definitely “attenuation of stress response.”
A daily habit
Perhaps the most important thing is that my cycling has become a habit, and I suspect that’s common to all the people in the article who cycle too. These are not one-off exercisers. They don’t have a gym subscription they’re wasting; biking isn’t a fad for them; they do this regularly and consistently.
Cycling is relatively accessible daily habit—it doesn’t require a lot of money or need fancy clothes or equipment. You save money when you bike instead of drive, you avoid road, rage and of course it’s better for the environment. You just get on your bike and off you go.
What this means for exceptional patient care
It’s the every day we need to think about—for our patients and ourselves. When we care for our own brains and bodies, we bring more presence, patience, and perspective into the clinic. That helps us listen better, tailor recommendations, and partner with patients on realistic, life‑integrated plans. Don’t be put off by the weather or the naysayers. Be positive, find solutions, and share your love of movement. I never thought I would be one of “those cyclists,” but it happened—and it’s made me a better clinician.
Practical ways to bring this into care:
1. Ask a lifestyle question at every visit. “What does your typical daily movement look like?”
2. Offer options, not ideals: walks, short bike rides, five‑minute stretch breaks – any movement is great!
3. Make it specific: “Could you try a 15‑minute cycle after dinner three nights this week?”
4. Reduce barriers: discuss bike safety, low‑cost or free bikes and helmets, and other community resources, such as beginner biking groups or free bike maintenance clinics.
5. Link habits to clinical goals patients care about (memory, mood, sleep).
6. Offer a model: share how you got started and your own simple routines.
7. Follow up: celebrate wins, troubleshoot setbacks, and adjust the plan together.
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This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.