Physical Activity Patterns and Brain Health: A Systematic Review About Weekend Warrior vs Regular Exercise on Neuropsychiatric Disorders

Abstract

This systematic review assessed whether the “weekend warrior” (WW) pattern of physical activity provides neuroprotective benefits comparable to regularly distributed activity. Data sources PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to December 2024 and updated in April 2025 (PROSPERO CRD42025638102). Eligibility criteria Observational studies reporting dementia, Parkinson’s disease, depression, anxiety, psychological distress, or cognitive outcomes in relation to WW vs regular physical activity were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias with ROBINS-E. Twelve studies comprising 614,882 participants met inclusion criteria. Both WW and regular activity were consistently associated with reduced risks of depression (adjusted OR/HR 0.46-0.79), psychological distress (OR ∼0.68), dementia (HR 0.68-0.75), and Parkinson’s disease/parkinsonism (HR 0.44-0.69 regular; 0.47-0.58 WW) compared with inactivity. Three studies suggested protective associations with anxiety (OR/HR 0.63-0.77). Cognitive performance was higher among active individuals, with some subgroups (elderly women, sedentary adults) showing slightly greater benefit with WW. No study demonstrated superiority of one activity pattern over the other, and even subthreshold physical activity conveyed measurable protection. Risk of bias was generally low to moderate. Achieving ≥150 minutes of moderate-to-vigorous physical activity weekly, whether condensed into one to two WW sessions or distributed across several days, provides comparable neuroprotective benefits. These findings support flexible, patient-centered exercise recommendations and reinforce that some activity is always better than none.