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. 2022 Mar 24:16:838968.
doi: 10.3389/fnhum.2022.838968. eCollection 2022.

The Effects of Combined Cognitive-Physical Interventions on Cognitive Functioning in Healthy Older Adults: A Systematic Review and Multilevel Meta-Analysis

Jennifer A Rieker  1   2 , José M Reales  1   2 , Mónica Muiños  1   3 , Soledad Ballesteros  1   2
Affiliations

The Effects of Combined Cognitive-Physical Interventions on Cognitive Functioning in Healthy Older Adults: A Systematic Review and Multilevel Meta-Analysis

Jennifer A Rieker et al. Front Hum Neurosci. .

Abstract

Research has shown that both physical exercise and cognitive training help to maintain cognition in older adults. The question is whether combined training might produce additive effects when the group comparisons are equated in terms of exercise intensity and modality. We conducted a systematic electronic search in MEDLINE, PsycInfo, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify relevant studies published up to February 2021. Seven hundred and eighty-three effect sizes were obtained from 50 published intervention studies, involving 6,164 healthy older adults, and submitted to a three-level meta-analysis. Results showed that combined training produced a small advantage in comparison to single cognitive training on executive functions, whereas both types of training achieved similar effects on attention, memory, language, processing speed, and global cognition. Combined training achieved higher training gains in balance than single physical training, indicating a transfer from cognitive training to balance. Performing cognitive and physical exercise simultaneously, and interactive training (e.g., exergames, square stepping) produced the largest gains in executive functions, speed, and global cognition, as well as the largest improvements in physical functions. Aerobic training was associated with higher effects in attention and fitness, whereas non-aerobic training produced larger effects in global cognition and balance. For all cognitive and physical outcomes, training resulted more advantageous when performed in a social context, even though individual training obtained similar results in balance as group training. Systematic Review Registration: www.crd.york.ac.uk/prospero/, identifier: CRD42020175632.

Keywords: aging; cognitive training; combined training; multidomain training; physical exercise; three-level meta-analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the search strategy.
Figure 2
Figure 2
Funnel plots with ES on the X-axis and standard error of the ES on the Y-axis for the estimated summary effects of (A) cognitive, (B) physical pre-post outcomes, (C) cognitive, and (D) physical pre-follow up outcomes.
Figure 3
Figure 3
Dot-plot figures for effect sizes for cognitive outcomes and physical outcomes by primary studies. Pink dots represent combined training vs. control, blue dots represent combined vs. single cognitive training, and orange dots, combined vs. single physical training. The size of the dot indicates the inverse of the ES variance scaled and represents the precision of the ES.
See this image and copyright information in PMC

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