Effects of Sport-Based Exercise Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis

Abstract

Exercise programs of moderate-to-vigorous intensity have been shown to improve the cognitive performance of older people. However, the specific effects of sports-based exercise programs on cognitive performance, particularly executive functions, remain unclear. Therefore, the purpose of this study is to clarify the effects of sports-based exercise programs on executive functions in older adults using a systematic review and meta-analysis of the scientific literature. A systematic review was conducted between 1 March and 1 July 2022, to look for published scientific evidence that analyzed different sports programs that may have affected executive function in healthy older adults. Longitudinal studies, which assessed the effects of sports interventions on healthy older adults, were identified through a systematic search of the four principal electronic databases: Web of Science, PubMed, Scopus, and EBSCO. A total of nine studies with a total of 398 subjects met the inclusion criteria and were classified based on one or more of the following categories: working memory, inhibition, and cognitive flexibility. The DerSimonian and Laird random-effects model was performed using the Comprehensive Meta-Analysis software to facilitate the analysis of the studies. Statistical significance was set at p ≤ 0.05. In terms of working memory, a small but positive significant effect was noted for the intervention group compared to the control group (effect size (ES) = 0.35, 95% confidence interval (CI) = 0.04-0.67; p = 0.029; I² = 36.7%); in terms of inhibition, the intervention had a small favoring but no significant effect compared to the control group (ES = 0.20, 95% CI = -0.42-0.84; p = 0.517; I² = 78.8%); and in terms of cognitive flexibility, the intervention had a small favoring but no significant effect compared to the control group (ES = 0.39, 95% CI = -0.11-0.89; p = 0.131; I² = 75.5%). Our findings suggest that healthy older adults should be encouraged to participate in sports to improve their working memory; however, more studies are required in this area to reach more robust conclusions. This systematic review was registered with the International Prospective Register of Systematic Reviews (registration number: CRD42022284788).

Keywords: cognitive flexibility; executive function; inhibitory control; older adults; sport; working memory.

Figure 1

A flow diagram of the studies included in the meta-analysis.

Figure 2

Forest plot of effects on working memory. Values shown are effect sizes (Hedges’s g) with 95% confidence intervals. The size of the plotted squares reflects the statistical weight of the study [44,46,48,49,50,54,88].

Figure 3

Forest plot of effects on inhibition. Values shown are effect sizes (Hedges’s g) with 95% confidence intervals. The size of the plotted squares reflects the statistical weight of the study [45,48,49,54,88].

Figure 4

Forest plot of effects on cognitive flexibility. Values shown are effect sizes (Hedges’s g) with 95% confidence intervals. The size of the plotted squares reflects the statistical weight of the study [44,49,50,51,88].