Combined exercise and diet modestly improves cognition in mild cognitive impairment

Photo by Navy Medicine / Unsplash

Mechanisms of ageing and development Published June 6, 2026 Medically reviewed June 6, 2026 Study authors: Castillo-Bernad Sergio, Moradell Ana, Gómez-Bruton Alejandro, Matute-Llorente Ángel, González-Agüero… PubMed ↗ DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Interpret the modest cognitive benefit of combined exercise and diet with caution due to small effect size and study variability.

This systematic review and meta-analysis evaluated the effect of combined exercise and dietary or nutritional supplementation interventions on cognitive function in healthy older adults or those with mild cognitive impairment. The analysis included 4013 participants and focused on global cognitive function as the primary outcome, with secondary outcomes of executive function and visual-perceptual ability.

The pooled analysis showed a statistically significant but modest improvement in global cognitive function (SMD 0.15, 95% CI 0.07 to 0.24). However, no significant improvements were observed for executive function or visual-perceptual ability. The authors note that the effect size is small and that the clinical relevance may be limited.

Key limitations include variability in methodological protocols, follow-up durations, cognitive assessment tools, and adherence measurement across included studies. Adverse events and tolerability were not reported, and funding sources were not disclosed.

The findings suggest that combined exercise and dietary interventions may have a potential role in attenuating cognitive decline, but the modest effect size and study heterogeneity warrant cautious interpretation. Further research with standardized protocols is needed before strong clinical recommendations can be made.

Study Details

Study typeMeta analysis

Sample sizen = 4,013

EvidenceLevel 1

Follow-up780.0 mo

PublishedJun 2026

PMID41999780

View Original Abstract ↓

Although life expectancy has increased, the proportion of years lived without disability has not improved at the same rate. This has contributed to the rising prevalence of dementia, which currently affects over 55 million people worldwide. In the absence of curative treatments, non-pharmacological strategies such as exercise and diet have attracted interest as a means of preserving cognitive function in older adults. This systematic review and meta-analysis evaluated the effectiveness of combined exercise and dietary or nutritional supplementation interventions on global cognitive function in healthy older adults or those with mild cognitive impairment. Following PRISMA guidelines (PROSPERO ID: CRD42024528600), we searched the following databases up to 1 May 2025: PubMed, Scopus, Web of Science and SportDiscus. Fourteen randomised controlled trials involving 4013 participants aged 65 years or over (mean age: 71.4) without diagnosed dementia were included. Global cognition was assessed using validated tools. The methodological quality was assessed using the PEDro scale and the risk of bias using Cochrane's RoB 2 tool. A random-effects meta-analysis was conducted using the DerSimonian-Laird method, with heterogeneity estimated via the I² statistic. A combined exercise and nutritional intervention significantly improved global cognitive function compared to the control group (SMD: 0.15; 95% CI: 0.07 to 0.24; I²: 50%). A sensitivity analysis that excluded multi-domain interventions confirmed this effect (d = 0.12; 95% CI: 0.02 to 0.22; I² = 0%). However, no significant improvements were found in specific domains, such as executive function or visual-perceptual ability. Variability in methodological protocols, follow-up durations, cognitive tools and adherence measurement limits comparability. While the observed effect size was modest, these findings, in the context of healthy ageing, suggest the potential for these combined interventions to attenuate cognitive decline and preserve functional autonomy, thereby highlighting their role in dementia prevention strategies.