Exercise improves executive function and memory in cognitively healthy older adults
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Key Takeaway
Consider recommending regular exercise to cognitively healthy older adults to support executive function and memory.
This meta-analysis synthesized evidence on exercise interventions for cognitively healthy older adults, including aerobic exercise, mind-body exercise, and other modalities. The primary findings indicate significant improvements in executive function (SMD = 0.31, 95% CI 0.18–0.44), memory (SMD = 0.26, 95% CI 0.14–0.38), and processing speed (SMD = 0.25, 95% CI 0.12–0.38) compared to passive controls. Working memory showed a borderline effect (SMD = 0.20, 95% CI 0.00–0.39), while verbal fluency did not improve significantly.
Comparisons between different exercise modalities (e.g., aerobic vs. mind-body) were largely inconclusive, as noted by the authors. The meta-analysis design precludes causal conclusions, and the authors call for further high-quality head-to-head trials with long-term follow-up to clarify optimal exercise types and dosing.
For clinical practice, these findings support recommending regular exercise to cognitively healthy older adults to potentially benefit executive function and memory, though the optimal modality remains unclear. The evidence is strongest for general exercise engagement rather than specific types.
View Original Abstract ↓
To compare the effects of different exercise modalities on multiple cognitive domains in cognitively healthy older adults and examine associations between exercise dose parameters and cognitive benefits.
Randomized controlled trials (RCTs) of exercise interventions in cognitively healthy older adults were systematically searched. Outcomes were classified into five domains: executive function, memory, verbal fluency, processing speed, and working memory. Random-effects pairwise meta-analyses were performed using standardized mean differences (SMDs). Prespecified subgroup analyses were conducted by participant and intervention characteristics. Linear random-effects meta-regressions examined frequency, session duration, intervention length, weekly dose, and total dose as continuous moderators. Bayesian network meta-analysis (NMA) was applied to compare and rank exercise modalities, distinguishing active and PCs.
Pairwise meta-analyses showed significant improvements in executive function (SMD = 0.31, 95% CI 0.18–0.44), memory (SMD = 0.26, 95% CI 0.14–0.38), and processing speed (SMD = 0.25, 95% CI 0.12–0.38), a borderline effect for working memory (SMD = 0.20, 95% CI 0.00–0.39), and no significant effect for verbal fluency. Meta-regression showed positive associations of training frequency and weekly dose with executive function, and of training frequency with processing speed. Bayesian NMA suggested aerobic exercise (AE) ranked higher for executive function and memory, while mind–body exercise (MBE) showed potential advantages for verbal fluency and working memory; however, most between-modality comparisons remained inconclusive.
Exercise benefits multiple cognitive domains in cognitively healthy older adults, with more consistent effects on executive function and memory. AE appears promising, but further high-quality head-to-head trials with long-term follow-up are warranted.
https://www.crd.york.ac.uk/PROSPERO/view/CRD420261290474, CRD420261290474.
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