[The research progress and outlook on the effects of different exercise modalities on working memory function in...

This review provides a comprehensive analysis of the effects of different exercise modalities on working memory function in middle-aged and older adults. It systematically reviews evidence from interventions including aerobic exercise, resistance training, and traditional mind-body exercises, examining their acute effects and long-term mechanisms of action. The findings indicate that aerobic exercise enhances working memory by improving cerebral blood flow, promoting neuroplasticity, and upregulating brain-derived neurotrophic factor (BDNF) levels. Resistance training activates neuroadaptive remodeling mechanisms and optimizes cerebral hemodynamics, thereby strengthening executive control. Traditional mind-body exercises improve the efficiency of cognitive control networks by restructuring functional neural networks and modulating the stress-inflammation axis. Combined exercise regimens, which integrate the synergistic effects of aerobic and resistance training, can further improve working memory performance. Mechanistic studies indicate that exercise interventions optimize neural network function through multiple pathways, including BDNF-mediated synaptic plasticity enhancement, coordinated regulation of the dopaminergic/noradrenergic systems, and improvements in cerebral blood flow and vascular reactivity. A dynamic individualized prescription design based on physiological and cognitive baseline characteristics may maximize cognitive health benefits. Future research should integrate multimodal neuroimaging technologies to clarify the neural mechanisms underlying exercise interventions and develop artificial intelligence-driven personalized prescription systems. At the policy level, integrating sports and medical services and promoting the large-scale application of exercise interventions in populations with multimorbidity are critical to addressing the public health challenges associated with population aging.