Effects of Exercise on Cancer-Related Cognitive Impairment: An Umbrella Review of Systematic Reviews and...

Cancer-related cognitive impairment (CRCI) is a common consequence of cancer and its treatments, with mild but significant deficits in memory, attention or executive function. These symptoms negatively affect survivors' quality of life, daily functioning, and return to work. Physical exercise is a promising non-pharmacological intervention, but current evidence remains methodologically heterogeneous.

This umbrella review synthesized evidence on the effects of physical exercise on cognitive function, both self-reported and objectively measured, in patients with cancer.

An umbrella review was conducted following PRIOR and PRISMA guidelines. Searches were performed in MEDLINE/PubMed, Scopus, Web of Science, and SPORTDiscus. Inclusion criteria, using the PICOS framework, targeted systematic reviews (with or without meta-analysis) evaluating exercise interventions and cognitive outcomes in cancer populations. Data were extracted on intervention characteristics, cognitive domains, and effect sizes. Methodological quality was appraised using GRADE and AMSTAR-2.

Eight systematic reviews were included with 80 primary articles and a total sample of 7536 participants. Six of the eight reviews analyzed various types of physical exercise, usually supervised 12-week programs, mostly assessing self-reported cognitive function. Exercise was associated with beneficial cognitive outcomes, though magnitude and consistency varied. The main improvements were in self-reported function, with participants reporting fewer complaints and enhanced perceptions of memory, attention, and executive function. Objective assessments revealed smaller but significant effects, particularly in executive function and processing speed. The most consistent interventions were 12-week aerobic programs at moderate intensity. Methodological heterogeneity and limited adherence to ICCTF standards were key sources of variability.

Physical exercise improves self-reported and objectively measured cognitive function in cancer populations, supporting its role as a complementary strategy for CRCI. However, evidence certainty is limited, requiring longitudinal studies with neuropsychological, neuroimaging, and biomarker approaches to refine recommendations.