Han Han, Zhang Jinhao, Zhang Fan, Li Fanghui, Wu Zhijian
Department of Police Physical Education, Jiangsu Police Institute, Nanjing, China.
School of Sport Sciences, Nanjing Normal University, Nanjing, China.
Front Aging Neurosci. 2025 Jul 11;17:1510773. doi: 10.3389/fnagi.2025.1510773. eCollection 2025.
Cognitive decline poses a significant challenge to healthy aging. While exercise is widely recognized for its cognitive benefits, the comparative efficacy of different exercise modalities and optimal intervention protocols for specific cognitive domains in older adults remains unclear. This network meta-analysis aimed to systematically compare the effects of five exercise modalities-resistance training, aerobic exercise, mind-body exercise, multicomponent exercise, and high-intensity interval training (HIIT)-on global cognitive function and major cognitive domains in cognitively healthy older adults, and to identify optimal intervention protocols and population subgroups most likely to benefit. A total of 58 randomized controlled trials (RCTs) were included, encompassing 4,349 healthy older adults from diverse geographical regions. Comprehensive searches were conducted in major electronic databases for RCTs evaluating exercise interventions on cognitive outcomes in adults aged 60 years and older. A network meta-analysis assessed the relative effects of each exercise modality on global cognition, executive function (including inhibitory control, task-switching ability, and working memory), and memory function. Subgroup analyses were performed based on intervention frequency, duration, participant age, and geographic region. Resistance training demonstrated the greatest improvement in global cognitive function (SMD = 0.55) and inhibitory control (SMD = 0.31, SUCRA = 82.1%), particularly with twice-weekly sessions of 45 min over 12 weeks. Mind-body exercise was most effective for executive function, especially task-switching ability (SMD = -0.58, SUCRA = 85.1%) and working memory (SMD = 2.45), with high-frequency, moderate-duration protocols yielding optimal results. Aerobic exercise was the most effective modality for enhancing memory function (SMD = 0.42). The largest cognitive benefits were observed in participants aged 65-75 years and in studies conducted in Asia. Different exercise modalities provide domain-specific cognitive benefits in healthy older adults. Personalized exercise prescriptions-emphasizing resistance training for global cognition, mind-body exercise for executive function, and aerobic exercise for memory-should be considered in clinical and public health settings. These findings support the integration of structured exercise interventions into aging and dementia prevention strategies, with particular attention to optimal protocol design and population targeting.
认知能力下降对健康老龄化构成了重大挑战。虽然运动因其对认知的益处而得到广泛认可，但不同运动方式对老年人特定认知领域的相对疗效以及最佳干预方案仍不明确。这项网络荟萃分析旨在系统比较五种运动方式——抗阻训练、有氧运动、身心运动、多组分运动和高强度间歇训练（HIIT）——对认知健康的老年人整体认知功能和主要认知领域的影响，并确定最佳干预方案以及最可能受益的人群亚组。总共纳入了58项随机对照试验（RCT），涵盖来自不同地理区域的4349名健康老年人。在主要电子数据库中进行了全面检索，以查找评估针对60岁及以上成年人认知结果的运动干预措施的RCT。一项网络荟萃分析评估了每种运动方式对整体认知、执行功能（包括抑制控制、任务转换能力和工作记忆）和记忆功能的相对影响。基于干预频率、持续时间、参与者年龄和地理区域进行了亚组分析。抗阻训练在整体认知功能（标准化均数差=0.55）和抑制控制（标准化均数差=0.31，累积排序曲线下面积=82.1%）方面显示出最大改善，特别是在12周内每周进行两次、每次45分钟的训练。身心运动对执行功能最有效，尤其是任务转换能力（标准化均数差=-0.58，累积排序曲线下面积=85.1%）和工作记忆（标准化均数差=2.45），高频、中等持续时间的方案产生最佳效果。有氧运动是增强记忆功能最有效的方式（标准化均数差=0.42）。在65 - 75岁的参与者以及在亚洲进行的研究中观察到最大的认知益处。不同的运动方式在健康老年人中提供特定领域的认知益处。在临床和公共卫生环境中应考虑个性化运动处方——强调针对整体认知的抗阻训练、针对执行功能的身心运动以及针对记忆的有氧运动。这些发现支持将结构化运动干预纳入衰老和痴呆预防策略，尤其要关注最佳方案设计和人群定位。
