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. 2021 Mar;34(2):91-101.
doi: 10.1177/0891988720915523. Epub 2020 Apr 15.

Physical Exercise Interventions Targeting Cognitive Functioning and the Cognitive Domains in Nondementia Samples: A Systematic Review of Meta-Analyses

David T Turner  1 , Mandy X Hu  2 , Ellen Generaal  2 , Daniel Bos  3   4 , M Kamran Ikram  3   5 , Alis Heshmatollah  3   5 , Lana Fani  3 , M Arfan Ikram  3 , Brenda W J H Penninx  1 , Pim Cuijpers  1
Affiliations

Physical Exercise Interventions Targeting Cognitive Functioning and the Cognitive Domains in Nondementia Samples: A Systematic Review of Meta-Analyses

David T Turner et al. J Geriatr Psychiatry Neurol. 2021 Mar.

Abstract

Objective: We investigated whether physical exercise interventions improve cognitive functioning in nondementia populations.

Methods: We conducted a systematic review of meta-analyses including only randomized controlled trials (RCTs). Two reviewers completed a systematic search of PubMed, Embase, PsychInfo, and Cochrane Controlled Register of Trials. Study characteristics, effect size data, and heterogeneity estimates were extracted and presented in tabular form. Methodological quality was assessed by 2 reviewers using the AMSTAR-2 checklist. The validity of results was considered based on AMSTAR-2 scores and study characteristics.

Results: We included 11 meta-analyses: 6 focused on disease-free older adults and 5 on mild cognitive impairment (MCI) excluding dementia. These meta-analyses summarized 97 unique RCTs. Methodological quality ranged from critically low to high. For overall cognitive functioning, which was the outcome of 6 meta-analyses, 1 showed improvement due to exercise interventions in disease-free older adults (g = 0.29, P < .01), while 2 reported nonsignificant effects. In patients with MCI, 3 meta-analyses reported significant benefits of exercise interventions on overall cognitive functioning (g = 0.25-0.57, P < .01). For cognitive domains such as attention and memory, there was limited evidence of beneficial effects of exercise demonstrated in either disease-free or MCI samples.

Conclusions: Exercise may improve overall cognitive functioning in disease-free older adults, but there is too little high-quality evidence to conclude whether this is achieved through improvement in any of the specific cognitive domains assessed. There is clearer evidence that exercise may improve cognitive functioning in MCI, but again there is limited evidence across most cognitive domains.

Keywords: cognitive functioning; meta-analysis; neurodegeneration; physical exercise interventions; systematic review.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of inclusion of studies.
See this image and copyright information in PMC

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