Home›Neurology› Resistance training shows largest effect for global cognition in Alzheimer's and Parkinson's disease
Resistance training shows largest effect for global cognition in Alzheimer's and Parkinson's diseaseResistance training shows strongest results for cognitive health in dementia
Frontiers in MedicinePublished September 25, 2026DOI ↗Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain
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Key Takeaway
Note that resistance training shows the largest effect for global cognition, but evidence is sparse and highly heterogeneous.
This network meta-analysis evaluated the impact of six exercise modalities—aerobic exercise (AE), mind-body exercise (MBE), resistance training (RT), multi-component exercise (MCE), flexibility training (FT), and functional training (FTr)—on global cognitive function in patients with Alzheimer's disease, Parkinson's disease, and mild cognitive impairment.
Results indicated that RT, MBE, MCE, FTr, and AE all showed improvements in global cognition compared to control groups, with RT yielding the largest effect size (SMD = 1.50, 95% CI 0.77, 2.23) and the most favorable SUCRA ranking. In contrast, flexibility training showed no clear effect (SMD = -0.20, 95% CI -1.27, 0.87).
The authors note significant limitations, including substantial heterogeneity (tau2 = 0.23; I2 = 80%) and sparse evidence for several modalities. The certainty of evidence ranged from low to very low.
Clinical utility is currently constrained by these limitations. While RT shows a large effect estimate, the sparse evidence and high heterogeneity mean results should be interpreted with caution. Further powered comparative trials are needed to confirm dose-related associations.
How this fits prior evidence
This meta-analysis addresses a gap in identifying the most effective exercise modality for cognitive decline in Alzheimer's and Parkinson's disease. While prior evidence has identified gut microbiota dysbiosis and periodontitis as factors associated with Parkinson's disease, this study focuses on non-pharmacological interventions for cognitive outcomes. It provides a comparative framework for exercise types, though the low certainty of evidence limits immediate clinical recommendations.
Living with Alzheimer's or Parkinson's disease often means facing a steady decline in memory and thinking skills. While many types of exercise are recommended, not all movements provide the same level of support for the brain. A large review of data from nearly 2,000 people looked at how different types of physical activity affect global cognitive function.
Researchers compared six types of exercise, including aerobic activity, mind-body exercises, and resistance training. The results showed that while aerobic and multi-component exercises helped, resistance training showed the largest improvement in cognitive scores. Other forms, like flexibility training, did not show a clear effect in this specific analysis.
It is important to note that the evidence for these findings is currently limited. Because the data came from many different sources, the level of certainty is low to very low. While resistance training ranked highest in this study, more large-scale trials are needed to confirm exactly how much and how often these exercises help.
What this means for you:
Resistance training showed the strongest results for improving cognitive function in people with dementia.
Common questions
Which type of exercise is best for memory and thinking?
Resistance training showed the largest improvement in global cognitive function compared to a control group. Other types, like aerobic and multi-component exercise, also showed improvements, while flexibility training did not show a clear effect.
Who can benefit from these exercise programs?
The study included people living with Alzheimer's disease, Parkinson's disease, and mild cognitive impairment. These are all conditions that affect memory and mental clarity.
How certain are these results?
The certainty of the evidence is currently low to very low. Because the data came from many different sources, there is a lot of variation, and more research is needed to confirm these findings.
BackgroundAlzheimer’s disease (AD), Parkinson’s disease (PD), and mild cognitive impairment (MCI) are commonly accompanied by cognitive decline. Although exercise is recommended as a non-pharmacological strategy, the comparative effects of different exercise modalities on global cognition remain uncertain.ObjectiveTo compare six exercise modalities—aerobic exercise (AE), mind–body exercise (MBE), resistance training (RT), multi-component exercise (MCE), flexibility training (FT), and functional training (FTr)—for global cognitive function in people with AD, PD, or MCI, and to explore dose-related associations.MethodsPubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to January 26, 2026. Randomized controlled trials (RCTs) were synthesized using a frequentist random-effects network meta-analysis (NMA) with standardized mean differences (SMDs) and 95% confidence intervals (CIs). Treatment rankings were summarized using SUCRA. Subgroup analyses, meta-regression, diagnosis-related sensitivity analyses, and CINeMA certainty assessments were also performed.ResultsTwenty-eight trials involving 1,993 participants were included. Compared with control group (CG), AE [SMD = 0.47, 95% CI (0.18, 0.77)], MBE [SMD = 0.79, 95% CI (0.46, 1.11)], RT [SMD = 1.50, 95% CI (0.77, 2.23)], MCE [SMD = 0.83, 95% CI (0.26, 1.40)], and FTr [SMD = 0.83, 95% CI (0.13, 1.53)] improved global cognition, whereas FT showed no clear effect [SMD = -0.20, 95% CI (−1.27,0.87)]. RT ranked first, followed by MCE, FTr, MBE, AE, and FT. Heterogeneity was substantial (τ2 = 0.23; I2 = 80%), although no statistically significant global incoherence was detected. RT remained first after the exclusion of AD, PD, or MCI studies. Studies lasting more than 12 weeks, delivered 3–5 times per week, and using sessions of 31–60 min showed favorable pooled effects, but subgroup interaction tests and meta-regression were not significant. Certainty of evidence ranged from low to very low.ConclusionAE, MBE, RT, MCE, and FTr may improve global cognition in people with AD, PD, or MCI. RT showed the largest effect estimate and the most favorable ranking. However, substantial heterogeneity and sparse evidence for several modalities limit firm conclusions. Exercise selection should be individualized, and dose-related findings require confirmation in adequately powered comparative trials.
