Exercise Effects on Inflammatory Markers in Middle-Aged and Older Adults: A Network Meta-Analysis
Xiaohong Xu1, Ting Liu1, Fang Wang2
1College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Objectives:
To systematically review the anti-inflammatory effects of different exercise types in middle-aged and older adults.
Design:
Systematic review and frequentist network meta-analysis.
Setting And Participants:
Participants were healthy community-dwelling middle-aged and older adults, irrespective of setting and region.
Methods:
Ten electronic databases were comprehensively searched from inception to September 1, 2025. Eligible randomized controlled trials were screened according to the inclusion criteria. Study selection, data extraction, and quality assessment were performed independently by 2 reviewers. Network meta-analysis and hierarchical ranking were conducted via Stata 18.0 (StataCorp LLC).
Results:
A total of 55 randomized controlled trials with 3516 participants were included. Resistance training exerted the strongest reduction in C-reactive protein. Aerobic training yielded optimal improvements in interleukin 6 and tumor necrosis factor alpha.
Conclusions And Implications:
Customized structured exercise effectively reduces age-related low-grade inflammation, especially aerobic and resistance training. These results offer actionable insights for clinicians and policymakers working to improve health outcomes in older adults.
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