The effects of different types of exercise on cognitive function in the older adults: a systematic review and network...

Global population aging is accelerating, and age-related cognitive decline has emerged as a core public health concern impacting the health and quality of life of older adults. Physical exercise, a low-cost, low-risk non-pharmacological intervention, has been validated to delay cognitive decline. However, there is no consensus yet on the relative effectiveness of different exercise types in improving cognitive function among older adults individuals with cognitive health issues and those with MCI. This highlights the urgent need to determine the best intervention strategies through evidence-based medicine.

A systematic literature search was conducted across PubMed, the Cochrane Library, Embase, SCOPUS, Web of Science and CNKI, with a search cutoff date of December 31, 2025. Initial database searches and reference list screening identified 3,816 records. Effect sizes were synthesized using the standardized mean difference (SMD) and 95% confidence intervals (CIs). The intervention efficacy of different exercise types was ranked via Surface Under the Cumulative Ranking Curve (SUCRA) values. Subgroup analyses, sensitivity analyses, and publication bias assessments were also performed.Statistical analyses adopted a random-effects consistency model for network Meta-analysis, with node-splitting method to test inconsistency.

A total of 18 randomized controlled trials (RCTs) involving 1,316 older adults were ultimately included. Meta-analysis results demonstrated that various exercise types exerted significant beneficial effects on cognitive function in older adults: MMSE, MT yielded the optimal intervention effect; MoCA, ST and RT were the most effective; WAIS, ST and AT demonstrated significant benefits; WCST, AT exhibited a statistically significant intervention effect (SMD = 0.61, 95% CI: 0.11-1.12).

Physical exercise effectively enhances multi-dimensional cognitive function in older adults, with distinct intervention advantages associated with different exercise types. In clinical practice, MT, RT, ST, or AT may be prioritized as intervention strategies based on the individual's cognitive assessment results and health status. It is recommended to adopt a moderate-intensity exercise regimen of "60-90 min per session, ≥3 times per week, and lasting ≥12 weeks" to maximize cognitive benefits. This study provides high-level evidence-based medical support for formulating exercise prescriptions to maintain cognitive function in older adults.