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Comparative effects of different exercise modalities on cognitive domains in older adults: a Bayesian network
Linlin Yang1, Zhichao Yuan2, Xiaoan Chen1
1College of Sports Science, Jishou University, Jishou, Hunan, China.
Objective:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420261290474, CRD420261290474.
