The impact of walking training on cognitive function in older adults: a meta-analysis

To investigate the effects of walking-based exercise on cognitive function in older adults and to determine whether different walking modalities produce improvements in specific cognitive domains.

PubMed, Embase, Web of Science, and the Cochrane Library was conducted through September 9, 2025. Eligible studies were randomized controlled trials (RCTs) comparing walking interventions-such as overground, interval, or virtual-reality treadmill walking-with non-aerobic control conditions. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using fixed- or random-effects models. The I ² statistic was applied to evaluate heterogeneity, while funnel plots together with Egger's regression analysis were used to detect potential publication bias.

Eight RCTs involving 772 participants (418 in the intervention and 354 in control groups) met the inclusion criteria. Walking interventions did not significantly enhance attention and executive function (SMD = 0.12, 95% CI -0.16 to 0.41; I ² = 83%), memory function (SMD = 0.04, 95% CI -0.13 to 0.21; I ² = 0%), or overall cognitive performance (SMD = 0.09, 95% CI -0.11 to 0.30; I ² = 46%). Subgroup analyses showed consistent results across different walking types. Sensitivity analyses confirmed the robustness of pooled estimates, and no publication bias was depicted (Egger's p = 0.411).

This meta-analysis found no evidence that walking training significantly improves cognitive function in older adults. These findings highlight the need for future large-scale, long-duration RCTs with standardized walking protocols, including walking speed, intensity, and domain-specific cognitive outcomes.

PROSPERO; Identifier CRD420261422255.