Educational pathophysiology diagram illustrating the proposed biological mechanisms by which table tennis contributes to the prevention of cognitive decline and dementia. The flowchart begins with a pictogram of a person playing table tennis, noting specific energy expenditures: 96% aerobic and 2% phosphagen energy. This activity triggers five key physiological pathways displayed in a central panel: improvement of cardiovascular factors, increased expression of neurotrophic factors (such as BDNF), increased cerebral blood flow, increased amyloid-β turnover, and a decreased inflammatory response. These factors are linked via directional arrows to a 3D illustration of a human brain labeled 'Enhance or improve cognitive function!', culminating in the clinical outcome of 'Prevent dementia!'. The diagram emphasizes the multi-modal neuroprotective benefits of complex physical exercise, targeting vascular, molecular, and structural aspects of brain health to mitigate age-related cognitive impairment.