Can table tennis protect the aging brain? A systematic review and meta-analysis in neurodegenerative diseases

Table tennis (TT) is an increasingly investigated intervention for supporting cognitive, motor, and psychosocial functions in older adults with neurodegenerative diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), and dementia. However, the available evidence remains limited, heterogeneous, and methodologically inconsistent.

Following PRISMA 2020 guidelines, a systematic search of PubMed, Scopus, Web of Science, and SPORTDiscus was conducted through June 30, 2025. Out of 499 screened records, ten studies met the inclusion criteria, with five eligible for quantitative synthesis. Random-effects meta-analyses (DerSimonian-Laird) were performed for cognitive and motor outcomes. Risk of bias was assessed using the JBI checklist, and certainty of evidence was evaluated with the GRADE framework.

The meta-analysis demonstrated large pooled effects for cognitive outcomes (MMSE: d = 1.44; MoCA: d = 1.31), motor function (UPDRS-III: d = 1.27), and dual-task gait (TUG: d = 0.93). Heterogeneity was low to moderate (I² = 18-42%), although the small number of studies warrants cautious interpretation. Sensitivity analyses confirmed the robustness of the findings, and no serious adverse events were reported.

TT appears to be a safe, feasible, and potentially effective non-pharmacological intervention for improving cognitive and motor outcomes in individuals with AD, PD, and dementia. Nevertheless, the limited number of small-scale studies and methodological variability restrict definitive conclusions, highlighting the need for high-quality trials.