Exercise intervention improved global cognitive function in adults aged 60+ with Alzheimer's disease.
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Key Takeaway
Consider individualized exercise programs for AD patients, noting exploratory dose–response associations and potential need for periodic adjustments.
This meta-analysis and meta-regression examined the effects of exercise interventions on global cognitive function in adults aged 60 years and older with Alzheimer's disease. The analysis pooled data from 23 studies involving a total sample of 1,868 participants. Participants in the intervention groups received structured exercise programs, while comparator groups consisted of passive controls without exercise.
The primary analysis revealed that exercise intervention significantly improved global cognitive function compared to control groups. The standardized mean difference was g = 0.22, with a 95% confidence interval ranging from 0.02 to 0.41 and a p-value less than 0.05. Additionally, cognitive benefits were significantly enhanced with increased weekly exercise frequency; a strengthening trend was observed when sessions exceeded five per week, although specific effect sizes for frequency were not reported.
Safety and tolerability data were not reported in the included studies, and no adverse events, serious adverse events, or discontinuations were documented in the available evidence. Key limitations include the exploratory nature of the dose–response associations and the potential for a plateau in long-term benefits, which suggests a need for periodic adjustments to exercise programs. The study design does not establish causality, and findings should be interpreted as associations rather than definitive clinical prescriptions.
These results provide scientific and actionable empirical evidence for designing precise and individualized exercise programs for this population. Clinicians should consider the potential for benefit while acknowledging the need for program adaptation over time to maintain efficacy.
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View Original Abstract ↓
ObjectiveThis study aimed to systematically evaluate the effects of exercise intervention on cognitive function in AD patients through meta-analysis, specifically investigating the dose–response relationships and moderating effects of various exercise prescription parameters including frequency, single-session duration, weekly total duration, total intervention duration, type, and intensity—on the magnitude of cognitive improvement. The findings are expected to provide scientific and actionable empirical evidence for designing precise and individualized exercise programs.MethodsRelevant literatures were systematically retrieved from eight databases up to August 2025, including PubMed, Web of Science, Embase, Emcare, Scopus, Cochrane Library, Ebsco, and SPORTDiscus. All included trials were randomized controlled trials (RCTs) involving adults aged 60 years and above. These studies examined the effects of exercise intervention on cognitive function in AD patients, compared with passive control groups without exercise. A multilevel meta-analysis was used to assess the impact of exercise on cognitive function outcomes in AD patients. Additionally, multivariate meta-regression analysis was employed to identify the exercise frequency (sessions per week) that maximizes cognitive improvement, as well as key moderating factors.ResultsData from 23 studies, involving 1,868 adults, were included. Exercise intervention significantly improved global cognitive function in AD patients (g = 0.22, 95% CI: 0.02–0.41, p 0.05). However, the cognitive benefits of exercise were significantly enhanced with increased weekly exercise frequency, with a notable strengthening trend observed when sessions exceeded five per week.ConclusionExercise intervention can effectively improve cognitive function in AD patients. “To optimize intervention outcomes, exercise prescription should consider higher frequency (e.g., more than five sessions per week may be associated with greater cognitive benefits) and the cumulative effect during the initial intervention phase (e.g., sustained beyond 12 weeks may represent a critical window for short-term improvement). In addition, a potential plateau in long-term benefits suggests the need for periodic program adjustments and multimodal exercise strategies. These findings should be interpreted as exploratory dose–response associations rather than definitive clinical prescriptions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1012816, identifier CRD420251012816.
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