Comparative Efficacy of Different Aquatic Exercise Modalities on Cognitive Function in The Elderly: A Systematic...

Area of Science:

• Gerontology
• Neuroscience
• Sports Science

Background:

• Cognitive decline is a significant concern in aging populations.
• Aquatic exercise offers potential cognitive benefits with reduced injury risk.
• Understanding the comparative effectiveness of different aquatic exercise types is crucial.

Purpose of the Study:

• To conduct a systematic review and network meta-analysis (NMA) on aquatic exercise modalities for cognitive function in older adults (≥60 years).
• To compare the effectiveness of aquatic cognitive-motor exercise, aerobic exercise, high-intensity interval training (HIIT), and strength training.
• To identify the optimal aquatic exercise strategy for enhancing cognitive function.

Main Methods:

• Systematic review and frequentist network meta-analysis (NMA) of randomized controlled trials (RCTs).
• Searched major electronic databases from inception to January 2026.
• Included 9 RCTs with 324 participants, analyzing cognitive outcomes.
• Interventions categorized: aquatic cognitive-motor exercise, aerobic exercise, HIIT, and strength training.

Main Results:

• Aquatic cognitive-motor exercise demonstrated the highest probability of effectiveness (SUCRA=85.36%).
• Aquatic aerobic exercise (61.44%) and strength training (51.80%) also showed benefits.
• Aquatic HIIT (49.12%) and land-based exercise (48.34%) had moderate effects.
• Only aquatic cognitive-motor exercise showed statistically significant improvements versus controls.

Conclusions:

• Aquatic cognitive-motor exercise may be the most effective aquatic modality for improving cognitive function in older adults.
• All aquatic exercise types provided cognitive benefits comparable to land-based exercise.
• Cognitive engagement, not just intensity, is key for intervention efficacy.
• Findings based on limited evidence (9 RCTs) require cautious interpretation.