Exercise has traditionally been associated with better health outcomes. According to the World Health Organization, there are various physical and mental health benefits to engaging in regular physical activity (PA). However, findings from a prospective cohort study published in Nature Communications in November 2025 by Lingjie Fan and colleagues suggest that the relationship between PA and mortality risk varies depending on the presence of epilepsy.
Epilepsy is a chronic neurological disorder. GlobalData epidemiologists estimate that there will be just over 1.28 million lifetime diagnosed prevalent cases of epilepsy in men and women, 18 and older, in the UK by the end of 2025. That number is expected to increase to 1.32 million cases by the end of 2030.
The primary outcomes of this study were to assess the association between PA levels and mortality in people with and without epilepsy. A total of 98,561 participants aged 40-69 were identified from UK Biobank, and two cohorts were established. The epilepsy group consisted of 1,167 individuals, and the non-epilepsy group consisted of 97,394 individuals. Between 2013 and 2015, participants were invited to wear a wrist-worn accelerometer for at least 72 hours to objectively measure their physical activity levels. Researchers quantified PA levels using accelerometer measurements and sorted participants into three distinct groups: sedentary, light PA (LPA), and moderate to vigorous PA (MVPA) durations.
The results indicated that mortality was higher in the epilepsy cohort (9.9%) than in the non-epilepsy cohort (4.1%), with the epilepsy group exhibiting a 2.39 times greater mortality rate. Sedentary behaviour exerted a protective effect against mortality risk in the epilepsy group compared to the non-epilepsy group, at a 15% reduction in risk. LPA and MVPA behaviours increased the risk of mortality in the epilepsy group compared to the non-epilepsy group by 55% and 9%, respectively. The study shows that a non-linear relationship between PA and epilepsy could exist. This could be due to various factors. For example, under certain circumstances, intense exercise could trigger seizures in those with epilepsy. However, more research needs to be conducted in this area as one limitation of this study was its observational nature.
This study provided important knowledge on how PA interacts differently in those with and without epilepsy regarding risk of mortality, and may indicate that physicians and other healthcare professionals should exercise caution when it comes to promoting lifestyle changes in relation to exercise to those with epilepsy.