{"publication_id":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","content_hash":"sha256:855ab3981864bb5b949ec52a0e2bf7973c8e9cefaff14d38b8ebb7c0572d0648","nodes":[{"id":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","type":"publication","title":"Hypothesis-Generating Brief: Exercise Cognition Effects — full paper"},{"id":"claim_1","type":"claim","text":"Evidence-honesty note: 36/41 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims. This paper synthesizes evidence on exercise cognition effects across 41 included source papers and 1801 high-confidence extracted claims. The evidence profile contains 5 direct clinical sources, 36 adjacent clinical sources, and no sources classified primarily as mechanistic or model-system evidence, with a high-density pairwise disagreement map across the evidence base. Positive study-level signals are summarized in the dosing and pharmacokinetics outcome class; null signals are summarized in the cognitive and safety and comorbidity outcome classes; negative signals are not the dominant direction in any outcome class; mixed or heterogeneous signals are summarized in the contextual adjacent evidence, muscle function, cardiometabolic, deficiency prevalence, frailty, and immune and inflammation outcome classes. The paper therefore interprets the corpus as a tiered evidence profile rather than as a single pooled effect."},{"id":"claim_2","type":"claim","text":"Evidence-honesty note: 36/41 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims."},{"id":"claim_3","type":"claim","text":"This paper synthesizes evidence on exercise cognition effects across 41 included source papers and 1801 high-confidence extracted claims."},{"id":"claim_4","type":"claim","text":"The evidence profile contains 5 direct clinical sources, 36 adjacent clinical sources, and no sources classified primarily as mechanistic or model-system evidence, with a high-density pairwise disagreement map across the evidence base."},{"id":"claim_5","type":"claim","text":"Positive study-level signals are summarized in the dosing and pharmacokinetics outcome class; null signals are summarized in the cognitive and safety and comorbidity outcome classes; negative signals are not the dominant direction in any outcome class; mixed or heterogeneous signals are summarized in the contextual adjacent evidence, muscle function, cardiometabolic, deficiency prevalence, frailty, and immune and inflammation outcome classes. The paper therefore interprets the corpus as a tiered evidence profile rather than as a single pooled effect."},{"id":"claim_6","type":"claim","text":"The conclusion is that exercise cognition effects should be treated as a bounded geroscience hypothesis: the retained clinical and adjacent evidence profile defines the scope for targeted testing, while mixed and null findings limit any unqualified anti-aging claim."},{"id":"claim_7","type":"claim","text":"For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint."},{"id":"claim_8","type":"claim","text":"This synthesis evaluates evidence on exercise cognition effects across 41 included source papers and 1801 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, indirect interventional hard-endpoint evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty."},{"id":"claim_9","type":"claim","text":"The corpus contains 5 direct clinical sources, 36 adjacent clinical sources, and no sources classified primarily as mechanistic or model-system evidence. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence."},{"id":"claim_10","type":"claim","text":"The thesis is: Across 41 curated reference papers, the evidence base for exercise cognition effects shows a context-dependent profile. Positive signals appear in: contextual other, muscle function. Negative signals appear in: cardiometabolic. Null findings dominate: contextual other, cognitive. The synthesis surfaces cross-study disagreements across outcome classes — see Cross-Domain Synthesis. The exercise cognition effects anti-aging case as currently constituted is incomplete: mechanistic plausibility coexists with mixed or sparse human-RCT evidence, and the boundary conditions remain to be established. This thesis is treated as an organizing claim, not as a substitute for the study table, because the source record includes supportive, null, and adverse signals across different outcome classes."},{"id":"claim_11","type":"claim","text":"This distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance."},{"id":"claim_12","type":"claim","text":"The mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof."},{"id":"claim_13","type":"claim","text":"Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection."},{"id":"claim_14","type":"claim","text":"Adverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints."},{"id":"claim_15","type":"claim","text":"The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific."},{"id":"claim_16","type":"claim","text":"The background evidence for exercise cognition effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Tan 2023, Khan 2026, Leischik 2021 are interpreted separately from mechanistic studies such as the retained evidence base, because these evidence roles answer different questions about aging biology and clinical translation."},{"id":"claim_17","type":"claim","text":"The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect."},{"id":"claim_18","type":"claim","text":"Across the retained sources, positive signals cluster around the contextual adjacent evidence, muscle function and cognitive outcome classes; null signals around the contextual adjacent evidence, cognitive and cardiometabolic outcome classes; and negative or adverse signals around the cardiometabolic outcome class. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation."},{"id":"claim_19","type":"claim","text":"The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty."},{"id":"claim_20","type":"claim","text":"The resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support."},{"id":"claim_21","type":"claim","text":"The following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text."},{"id":"claim_22","type":"claim","text":"Risk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification."},{"id":"claim_23","type":"claim","text":"Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, cognitive, contextual adjacent evidence, deficiency prevalence, dosing and pharmacokinetics, frailty, immune and inflammation, muscle function, safety and comorbidity); within-class agreement, disagreement, and directness gaps surfaced explicitly. Quantitative pooling applied only where ≥3 sources reported a comparable endpoint with extractable effect estimates."},{"id":"claim_24","type":"claim","text":"Source retrieval, claim extraction, evidence routing, and prose drafting were assisted by large language models under a deterministic audit-trail protocol. Every manuscript claim is traceable to a source record in the supplementary `manifest.json`. Final eligibility and interpretation decisions are author-verified."},{"id":"claim_25","type":"claim","text":"| Evidence domain | Corpus slice | Strongest signal | Directness | Main limitation |"},{"id":"claim_26","type":"claim","text":"| Exercise Cognition Effects / Contextual Adjacent Evidence | n=24; claims=1044 | significant source statistic in 18/24 sources; receipt-level direction coded unclear | 3 direct; 13 indirect; 1 protocol; 7 review | limited corpus depth in this outcome class |"},{"id":"claim_27","type":"claim","text":"| Exercise Cognition Effects / Cognitive | n=6; claims=126 | significant source statistic in 2/6 sources; receipt-level direction coded null | 1 direct; 2 indirect; 3 review | limited corpus depth in this outcome class |"},{"id":"claim_28","type":"claim","text":"| Exercise Cognition Effects / Cardiometabolic | n=2; claims=76 | significant source statistic in 2/2 sources; receipt-level direction coded null | 2 indirect | limited corpus depth in this outcome class |"},{"id":"claim_29","type":"claim","text":"Skeletal and muscle context: 3 sources; significant source statistic in 1/3 sources; receipt-level direction coded null."},{"id":"claim_30","type":"claim","text":"Outcome-class note:** Contextual Adjacent Evidence denotes background, boundary-condition, or adjacent-outcome sources. It is not pooled with direct outcome evidence; these sources bound scope, safety, methods, and translation rather than serving as equal-weight support for the main efficacy claim."},{"id":"source_1","type":"source","study":"Effects of multimodal agility-like exercise training compared to inactive controls and alternative training on physical performance in older adults: a systematic review and meta-analysis","year":2021,"doi":"10.1186/s11556-021-00256-y","url":"https://doi.org/10.1186/s11556-021-00256-y","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Morat 2021","excerpt":"BACKGROUND: Multimodal exercise training (MT) as a time-efficient training modality promotes a wide range of physical dimensions. Incorporating agility-like training aspects (coordination, changes of direction and velocity) into MT may further enhance physical outcomes highly relevant for activities of daily living. This meta-analysis investigated the effects of multimodal agility-like exercise training (MAT) on physical and cognitive performance compared to inactive (IC) and active controls (AC) in older adults. METHODS: Literature search was conducted in four health-related databases (PubMed, SCOPUS, SPORTDiscus and Web of Science). Randomized controlled trials with pre-post testing applying MAT (including aspects of training with at least two different traditional domains: strength, balance, endurance) and an agility-like component in community-dwelling older adults were screened for eligibility. Standardized mean differences (SMD) adjusting for small sample sizes (hedges' g) were used to extract main outcomes (strength, gait, balance, mobility, endurance, cognition). Statistical analysis was conducted using a random effects inverse-variance model."},{"id":"source_2","type":"source","study":"The benefits of regular aerobic exercise training on cerebrovascular function and cognition in older adults","year":2023,"doi":"10.1007/s00421-023-05154-y","url":"https://doi.org/10.1007/s00421-023-05154-y","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Bliss 2023","excerpt":"We compared the differences in cerebrovascular and cognitive function between 13 aerobic exercise trained, older adults and 13 age-, height- and sex-matched sedentary, untrained controls. We determined whether other measures accounted for differences in cerebrovascular and cognitive function between these groups and examined the associations between these functions. Participants undertook anthropometric, mood, cardiovascular, exercise performance, strength, cerebrovascular, and cognitive measurements, and a blood collection. Transcranial Doppler ultrasonography determined cerebrovascular responsiveness (CVR) to hypercapnia and cognitive stimuli. The trained group had a higher CVR to hypercapnia (80.3 ± 7.2 vs 35.1 ± 6.7%, P < 0.001), CVR to cognitive stimuli (30.1 ± 2.9 vs 17.8 ± 1.4%, P = 0.001) and total composite cognitive score (117 ± 2 vs 98 ± 4, P < 0.001) than the controls. These parameters no longer remained statistically different between the groups following adjustments for covariates. There were positive correlations between the total composite cognitive score and CVR to hypercapnia (r = 0.474, P = 0.014) and CVR to cognitive stimuli (r = 0.685, P < 0.001)."},{"id":"source_3","type":"source","study":"5 Years of Exercise Intervention Did Not Benefit Cognition Compared to the Physical Activity Guidelines in Older Adults, but Higher Cardiorespiratory Fitness Did. A Generation 100 Substudy","year":2021,"doi":"10.3389/fnagi.2021.742587","url":"https://doi.org/10.3389/fnagi.2021.742587","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Sokolowski 2021","excerpt":"Background: Aerobic exercise is proposed to attenuate cognitive decline in aging. We investigated the effect of different aerobic exercise interventions and cardiorespiratory fitness (CRF) upon cognition throughout a 5-year exercise intervention in older adults. Methods: 106 older adults (52 women, age 70-77 years) were randomized into high-intensity interval training (HIIT; ∼90% peak heart rate), moderate-intensity continuous training (MICT; ∼70% peak heart rate), or control for 5 years. The HIIT and MICT groups performed supervised training twice weekly, while the control group was asked to follow the national physical activity guidelines (30 min of physical activity/day). At baseline, 1-, 3-, and 5-year follow-up, participants partook in cognitive testing (spatial memory, verbal memory, pattern separation, processing speed, working memory, and planning ability), underwent clinical testing, and filled out health-related questionnaires. Linear mixed models were used to assess the effects of the exercise group and CRF (measured as peak and max oxygen uptake) on each cognitive test."},{"id":"source_4","type":"source","study":"Effects of 5-Year Exercise Training on Cognition in Older Adults: 10-Years Follow-Up from the Generation 100 Study","year":2025,"doi":"10.1186/s40798-025-00956-0","url":"https://doi.org/10.1186/s40798-025-00956-0","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Bakken 2025","excerpt":"BACKGROUND AND AIM: The rapid aging of the global population is expected to lead to an increase in the incidence and prevalence of neurodegenerative diseases. Endurance exercise training is considered one of the most effective forms of prevention against neurodegenerative diseases. This study investigated the effects of a 5-year exercise training intervention at varying intensities on cognitive function in healthy older adults. METHODS: 1486 healthy older men (n = 735) and women (n = 751) aged 70-77 years from Trondheim, Norway, were randomly assigned to high-intensity interval training (HIIT, n = 382), moderate-intensity continuous training (MICT, n = 367), or a control group (n = 737) following the national physical activity (PA) guidelines. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) score after 3, 5 and 10 years. A linear mixed model was used to estimate the effect of the exercise intervention between the groups. Measures of physical health, such as cardiorespiratory fitness (CRF), and PA level was also measured."},{"id":"source_5","type":"source","study":"Efficacy of traditional Chinese exercises on cognitive function in older adults: a systematic review and meta-analysis of randomised controlled trials","year":2026,"doi":"10.1093/ageing/afag168","url":"https://doi.org/10.1093/ageing/afag168","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Li 2026","excerpt":"BACKGROUND: Cognitive impairment is a significant health concern among older adults, highlighting the need for non-pharmacological interventions, such as mind-body exercises. However, a comprehensive synthesis of the effects of various traditional Chinese exercises (TCEs) on cognitive function in older adults is lacking. METHODS: A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted. Six databases were searched from inception to 2 May 2024 for studies examining the effects of TCEs on cognitive outcomes in adults aged 60 years and older. Studies were included if they were RCTs involving TCEs and reported outcome measures for global cognition, or individual cognitive domains. RESULTS: Twenty-eight RCTs with a total of 2297 participants were included. Meta-analysis revealed that TCEs led to significant improvements in global cognition: Montreal Cognitive Assessment [mean differences (MD) = 1.67; 95% confidence interval (CI): (1.20, 2.14)], Mini-Mental State Examination [MD = 0.76; 95% CI: (0.04, 1.48)]; executive function: Trail Making Test (B-A) [MD = -7.96; 95% CI: (-15.34, -0.59)], Category Fluency for Animals [MD = 2.96, 95% CI (2.08, 3."},{"id":"source_6","type":"source","study":"Effects of aerobic exercise on cognitive function in older adults with mild cognitive impairment: a systematic review and meta-analysis","year":2026,"doi":"10.3389/fpsyt.2025.1741998","url":"https://doi.org/10.3389/fpsyt.2025.1741998","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Zhao 2026","excerpt":"BACKGROUND: Regular exercise may boost cognition in older adults with MCI, but the effectiveness of different aerobic exercise (AE) modalities is unclear. We conducted a meta-analysis to assess AE's impact on cognition in this group. OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the effects of AE on cognitive function in older adults with MCI. METHODS: We searched PubMed, Embase, Web of Science, and the Cochrane Library up to July 2025 and referenced included articles. RCTs with aerobic exercise and outcomes for global cognition and specific cognitive domains in older MCI adults were included. Data was pooled using mean difference, standardized random-effect model, and 95% CI with RevMan V.5.4 and Stata 16.0. RESULTS: A total of 33 studies with 1996 participants were included. The results revealed that AE exerted a significant positive effect on global cognition (SMD = 0.81, 95% CI (0.50, 1.12), Z = 5.07, p=0.00) and a moderate positive effect on memory (SMD = 0.34, 95% CI (0.06, 0.63); Z = 2.33, p = 0.02). Notably, no significant improvements were observed in executive function, attention, processing speed, language, or visuospatial abilities."},{"id":"source_7","type":"source","study":"Impact of Exercise and Cognitive Stimulation Therapy on Physical Function, Cognition and Muscle Mass in Pre-Frail Older Adults in the Primary Care Setting: A Cluster Randomized Controlled Trial","year":2023,"doi":"10.1007/s12603-023-1928-7","url":"https://doi.org/10.1007/s12603-023-1928-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Tan 2023","excerpt":"OBJECTIVES: Multicomponent exercise program have shown to improve function and cognition in older adults but studies on pre-frail older adults in the primary care setting are limited. This study aimed i) to evaluate impact of 6 months exercise (Ex) versus complementary effect of 3 months of cognitive stimulation therapy (CST) to 6 months of Ex (Ex+CST) on physical function, muscle mass and cognition versus control group at 3, 6 and 12 months ii) inflammatory biomarkers such as Interleukin-6 (IL-6) and Tumor Necrosis Factor Alpha (TNF-α). DESIGN: Cluster randomised control trial. SETTING AND INTERVENTION: Pre-frail older adults ≥ 65 years attending primary care clinic. Two intervention groups i) Ex 6 months ii) CST 3 months with Ex 6 months. MEASUREMENTS: At 0, 3, 6 and 12 months, questionnaires (on demographics, physical function, cognition, and depression) were administered and physical function assessment (gait speed, short physical performance battery (SPPB) test, handgrip strength, five times sit-to-stand (5x-STS)) was conducted. Muscle mass and its surrogates such as phase angle and body cell mass were measured using bioelectrical impedance analysis machine."},{"id":"source_8","type":"source","study":"Effects of digitalized traditional Chinese exercises on the physical and mental health and quality of life of older adults: a systematic review and meta-analysis of randomized controlled trials","year":2025,"doi":"10.3389/fpubh.2025.1725847","url":"https://doi.org/10.3389/fpubh.2025.1725847","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Tu 2025","excerpt":"OBJECTIVE: This study aims to systematically evaluate the effects of digitalized traditional Chinese exercises (TCEs) on physical function, cognitive function, mental health, and quality of life in older adults. METHODS: Searches were conducted in the PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, and Wan Fang databases from their inception until 28 September 2025 to identify relevant randomized controlled trials. Outcome measures included physical function, cognition, depression, and quality of life. The Cochrane Risk of Bias Assessment Tool and GRADE criteria were used to assess the quality of the studies. Statistical analyses were performed using RevMan 5.3 and Stata 17.0. RESULTS: Sixteen trials involving 1,604 participants were included in this study. Low to moderate-certainty evidence showed that digitalized TCEs significantly improved functional mobility (WMD = -0.81; 95% CI, -1.28 to -0.33; p = 0.0009; I 2 = 76%), balance function (SMD = 0.88; 95% CI, 0.68 to 1.08; p < 0.00001; I 2 = 0%), and global cognition (WMD = 1.98; 95% CI, 1.44 to 2.52; p < 0.00001; I 2 = 84%)."},{"id":"source_9","type":"source","study":"Mind body exercise improves cognitive function more than aerobic- and resistance exercise in healthy adults aged 55 years and older – an umbrella review","year":2023,"doi":"10.1186/s11556-023-00325-4","url":"https://doi.org/10.1186/s11556-023-00325-4","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Blomstrand 2023","excerpt":"Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults ≥ 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA)."},{"id":"source_10","type":"source","study":"Effects of aerobic exercise and computer-based cognitive training on cognition, functional independence, quality of life, and salivary cortisol levels in older adults with mild cognitive impairment: a randomized trial","year":2026,"doi":"10.3389/fnagi.2026.1776069","url":"https://doi.org/10.3389/fnagi.2026.1776069","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Khan 2026","excerpt":"BACKGROUND: Mild Cognitive Impairment (MCI) represents an intermediate stage between normal aging and dementia, characterized by measurable cognitive decline without significant loss of functional independence. Non-pharmacological interventions, particularly aerobic exercise and cognitive training, have demonstrated potential benefits; however, their combined effects and underlying neurobiological mechanisms remain inadequately explored. OBJECTIVE: To investigate the effects of aerobic exercise combined with computer-based cognitive training on cognitive function, functional independence, health-related quality of life, and salivary cortisol levels in older adults with MCI. METHODS: This assessor-blinded, two-arm randomized controlled trial included 60 older adults (60-85 years) diagnosed with MCI. Participants were randomized to either an intervention group receiving aerobic exercise plus computer-based cognitive training ( n = 28) or an active comparison group receiving aerobic exercise with conventional cognitive training ( n = 28). Interventions were delivered over 12 weeks, with assessments conducted at baseline, post-intervention (12 weeks), and follow-up (16 weeks)."},{"id":"source_11","type":"source","study":"Effects of exercise, cognitive, and dual-task interventions on cognition in type 2 diabetes mellitus: A systematic review and meta-analysis","year":2020,"doi":"10.1371/journal.pone.0232958","url":"https://doi.org/10.1371/journal.pone.0232958","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Cooke 2020","excerpt":"INTRODUCTION: Previous evidence has shown significant effects of exercise, cognitive and dual-task training for improving cognition in healthy cohorts. The effects of these types of interventions in type 2 diabetes mellitus is unclear. The aim of this research was to systematically review evidence, and estimate the effect, of exercise, cognitive, and dual-task interventions on cognition in type 2 diabetes mellitus. METHOD: Electronic databases including PubMed, EMBASE, CINAHL, PsycINFO, SPORTDiscus, and MEDLINE were searched for ongoing and completed interventional trials investigating the effect of either an exercise, cognitive or dual-task intervention on cognition in type 2 diabetes mellitus. RESULTS: Nine trials met the inclusion criteria-one dual-task, two cognitive, and six exercise. Meta-analyses of exercise trials showed no significant effects of exercise on measures of executive function (Stroop task, SMD = -0.31, 95% CI -0.71-0.09, P = 0.13, trail making test part A SMD = 0.28, 95% CI -0.20-0.77 P = 0.25, trail making test part B SMD = -0.15, 95% CI -0.64-0.34 P = 0.54, digit symbol SMD = 0.09, 95% CI -0.39-0.57 P = 0.72), and memory (immediate memory SMD = 0."},{"id":"source_12","type":"source","study":"Wuqinxi exercise for mind and balance: Enhancing cognition, fall prevention, and quality of life in older adults with mild cognitive impairment","year":2026,"doi":"10.1371/journal.pone.0346490","url":"https://doi.org/10.1371/journal.pone.0346490","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Wen 2026","excerpt":"BACKGROUND: The risk of falls is a global public health issue, with over 38 million disability-adjusted life years lost annually due to falls. However, older adults with mild cognitive impairment (MCI) are more likely to fall and suffer more severe injuries compared to cognitively normal older adults, which also has an impact on their quality of life. METHODS: This study was a randomized, controlled trial with two parallel groups, allocated in a 1:1 ratio using a concealed allocation mechanism and assessor blinding. 53 participants were randomly assigned to the 12-week Wuqinxi exercise group or the 12-week stretching exercise group. Overall cognitive function, risk of falls, and quality of life were assessed at baseline and at post. Independent t-tests and non-parametric tests were used to compare the outcome variables between the two groups. RESULTS: There were no significant differences in baseline demographic characteristics or assessment indicators between Wuqinxi exercise group and stretching exercise group (P > 0.05), indicating comparability between the groups."},{"id":"source_13","type":"source","study":"Longitudinal effects of exercise according to the World Health Organization guidelines on cognitive function in middle-aged and older adults","year":2022,"doi":"10.3389/fpubh.2022.1009775","url":"https://doi.org/10.3389/fpubh.2022.1009775","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Kim 2022","excerpt":"PURPOSE: To investigate the longitudinal effects of adequate exercise, defined as an exercise duration of ≥150 min/week by the World Health Organization (WHO), on cognitive function in middle-aged adults. METHODS: This study was a longitudinal panel analysis using secondary data obtained from the Korean Longitudinal Study of Aging (KLoSA) database, with 4,825 participants registered and comprising five rounds of survey data in 2-year intervals from 2010 to 2018. The participants were divided into the adequate exercise (≥150 min/week), deficient exercise (<150 min/week), and no exercise groups according to the WHO definition, and their cognitive decline over the 8-year period was analyzed. Further, we investigated the longitudinal effects of exercise using a fixed effects model with cognitive function as the dependent variable. RESULTS: In the dementia group, both deficient (<150 min/week) and adequate (≥150 min/week) exercises had statistically significantly positive effects on cognitive function. However, the coefficient size was not significantly larger in the adequate exercise group than in the deficient exercise group."},{"id":"source_14","type":"source","study":"Traditional Chinese exercise for quality of life, cognition, sleep in Parkinson’s disease: a systematic review and meta-analysis","year":2026,"doi":"10.3389/fpsyg.2026.1824910","url":"https://doi.org/10.3389/fpsyg.2026.1824910","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yan 2026","excerpt":"OBJECTIVE: This review aims to synthesize the current evidence on the potential effects of Traditional Chinese Exercise (TCE) on cognition, sleep quality, and quality of life (QoL) in Parkinson's disease (PD) patients, and to explore intervention characteristics that may be associated with beneficial outcomes. METHODS: We searched five major databases (PubMed, Web of Science, EBSCO, Cochrane, and Scopus) for randomized controlled trials up to March 2025. Studies assessing TCE in patients with PD were included. Data were pooled using the standardized mean difference (SMD) and 95% confidence interval (CI). RESULTS: Fifteen trials met the inclusion criteria. TCE demonstrated significant overall improvements in cognition (SMD = 0.87, 95% CI [0.56, 1.19]), sleep quality (SMD, -0.88, 95% CI [-1.41, -0.34]), and QoL (SMD, -0.48, 95% CI [-0.66, -0.29]). Subgroup analyses revealed that interventions lasting ≥12 weeks and totaling ≥180 min per week may be associated with more favorable outcomes, although these findings should be interpreted cautiously. For exercise type, Tai Chi was particularly effective for cognition (SMD, 0.91, p < 0.0001) and QoL (SMD, -0.70, p < 0."},{"id":"source_15","type":"source","study":"The Effects of Aerobic Exercise Training on Cerebrovascular and Cognitive Function in Sedentary, Obese, Older Adults","year":2022,"doi":"10.3389/fnagi.2022.892343","url":"https://doi.org/10.3389/fnagi.2022.892343","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Bliss 2022","excerpt":"Cerebrovascular function and cognition decline with age and are further exacerbated by obesity and physical inactivity. This decline may be offset by aerobic exercise training (AT). We investigated the effects of 16 weeks AT on cerebrovascular and cognitive function in sedentary, obese, older adults. Twenty-eight participants were randomly allocated to AT or a control group. Before and after the intervention, transcranial Doppler ultrasonography was used to measure the cerebrovascular responsiveness (CVR) to physiological (hypercapnia, 5% carbon dioxide) and cognitive stimuli. AT increased the CVR to hypercapnia (98.5 ± 38.4% vs. 58.0 ± 42.0%, P = 0.021), CVR to cognitive stimuli (25.9 ± 6.1% vs. 16.4 ± 5.4%, P < 0.001) and total composite cognitive score (111 ± 14 vs. 104 ± 14, P = 0.004) compared with the control group. A very strong relationship was observed between the number of exercise sessions completed and CVR to cognitive stimuli ( r = 0.878, P < 0.001), but not for CVR to hypercapnia ( r = 0.246, P = 0.397) or total composite cognitive score ( r = 0.213, P = 0.465)."},{"id":"source_16","type":"source","study":"Optimal type and dose of exercise to improve cognitive function in healthy and pre-sarcopenic older adults: a bayesian network meta-analysis of randomized controlled trials","year":2026,"doi":"10.1186/s11556-026-00404-2","url":"https://doi.org/10.1186/s11556-026-00404-2","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yang 2026","excerpt":"BACKGROUND: Exercise is increasingly recognized as a non-pharmacological strategy for cognitive aging; however, comparative evidence across modalities, phenotypes, and doses is limited. METHODS: We conducted a Bayesian network meta-analysis of 38 randomized controlled trials (N = 4,047; 88 arms). The interventions included aerobic, resistance, multimodal, and other exercise formats compared with non-exercise controls. The primary outcome was global cognition. Analyses were stratified by age (< 70 vs. ≥70 years) and phenotype (healthy vs. pre-sarcopenic). Dose-response relationships were modeled using the weekly volume (MET·min/week). RESULTS: Aerobic (standardized mean difference [SMD] 0.58, 95% CI 0.33-0.83), resistance (0.62, 0.35-0.88), and multimodal programs (0.68, 0.40-0.95) significantly improved cognition compared to the control, with smaller effect sizes. Healthy older adults benefited most from aerobic (0.88, 0.55-1.20) and resistance training (0.80, 0.42-1.19), whereas multimodal programs were most effective for pre-sarcopenia (0.60, 0.29-0.90)."},{"id":"source_17","type":"source","study":"Biological sex as a tailoring variable for exercise prescription in hospitalized older adults","year":2024,"doi":"10.1016/j.jnha.2024.100377","url":"https://doi.org/10.1016/j.jnha.2024.100377","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Asteasu 2024","excerpt":"BACKGROUND: Sex-based differences in the clinical presentation and outcomes are well-established in patients hospitalized for geriatric syndromes. We aimed to investigate sex differences in response to in-hospital exercise on function, strength, cognition, and quality of life in acute care admissions. METHODS: 570 patients (mean age 87 years, 298 females [52.3%]) admitted to acute care for elderly units were randomized to multicomponent exercise emphasizing progressive resistance training or usual care. Functional assessments included Short Physical Performance Battery (SPPB), grip strength, Mini-Mental State Examination (MMSE), and health-related quality of life (EQ-VAS). RESULTS: Exercising females showed more significant SPPB improvements than males (between-group difference 1.48 points, p = 0.027), exceeding the minimal clinically significant difference. While female participants significantly increased handgrip strength and male patients improved cognition after in-hospital exercise compared to the control group (all p < 0.001), no sex differences occurred. CONCLUSIONS: Females demonstrate more excellent physical function improvements compared to male older patients."},{"id":"source_18","type":"source","study":"Large-Scale Network Connectivity and Cognitive Function Changes After Exercise Training in Older Adults with Intact Cognition and Mild Cognitive Impairment","year":2023,"doi":"10.3233/ADR-220062","url":"https://doi.org/10.3233/ADR-220062","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Won 2023","excerpt":"BACKGROUND: Despite growing evidence regarding the association between exercise training (ET) and functional brain network connectivity, little is known about the effects of ET on large-scale within- and between-network functional connectivity (FC) of core brain networks. OBJECTIVE: We investigated the effects of ET on within- and between-network functional connectivity of the default mode network (DMN), frontoparietal network (FPN), and salience network (SAL) in older adults with intact cognition (CN) and older adults diagnosed with mild cognitive impairment (MCI). The association between ET-induced changes in FC and cognitive performance was examined. METHODS: 33 older adults (78.0±7.0 years; 16 MCI and 17 CN) participated in this study. Before and after a 12-week walking ET intervention, participants underwent a graded exercise test, Controlled Oral Word Association Test (COWAT), Rey Auditory Verbal Learning Test (RAVLT), a narrative memory test (logical memory; LM), and a resting-state fMRI scan. We examined the within ( W ) and between ( B ) network connectivity of the DMN, FPN, and SAL."},{"id":"source_19","type":"source","study":"Intermittent low-intensity and moderate-intensity exercise effects on cognition in community-dwelling older adults: a pilot study exploring biological mechanisms","year":2024,"doi":"10.3389/fnagi.2024.1432909","url":"https://doi.org/10.3389/fnagi.2024.1432909","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Gujral 2024","excerpt":"BACKGROUND/OBJECTIVE: To examine the cognitive benefits of 6 months of prescribed intermittent exercise (10-min bouts totaling 150 weekly minutes) in community-dwelling older adults, comparing effects of low-intensity movement (LIM) and moderate-intensity aerobic exercise (aerobic exercise; AE) training; and exploring biological mechanisms of exercise-related cognitive improvement. METHOD: Twenty-five adults (>60 years old) participated in a 6-month controlled trial and were randomized into LIM or AE intermittent training. Cognition was assessed using a neuropsychological test battery including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), California Verbal Learning Test, 2nd Edition (CVLT-II), and Delis-Kaplan Executive Function System (D-KEFS). Neuroimaging measures were collected using a 7 T human MRI scanner. Serologic neurotrophic and inflammatory factors were analyzed using Luminex multiplex assays [brain derived neurotrophic factor (BDNF); vascular endothelial growth factor (VEGF)]; interleukin-6 (IL-6), C-reactive protein (CRP), plasminogen activator inhibitor (PAI-1)."},{"id":"source_20","type":"source","study":"Exercise Improves Cognitive Function—A Randomized Trial on the Effects of Physical Activity on Cognition in Type 2 Diabetes Patients","year":2021,"doi":"10.3390/jpm11060530","url":"https://doi.org/10.3390/jpm11060530","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Leischik 2021","excerpt":"BACKGROUND: Lifestyle habits strongly influence health. It is strongly believed that physical activity may improve cognitive function. We examined the association between two kinds of physical activity and cognitive function in patients with type 2 diabetes. METHODS: Using a random allocation sequence, 49 patients with type 2 diabetes (metformin, insulin, and diet-controlled) were randomized to a 12-week intervention of either walking 40 min three times a week ( n = 17), performing pedometer-controlled activity (E-health, goal 10,000 steps a day, n = 17), or receiving standard care ( n = 16 controls). We prospectively examined cognitive function, metabolic parameters, height, and weight. The groups were compared using linear regression adjusted for age. RESULTS: Compared with the control group ( n = 16), nonverbal memory improved significantly after the intervention in the walking group ( n = 16) (28.2 (+/-6.1) vs. 35.3 (+/-5.3) p < 0.001) and the E-health (pedometer) group (( n = 17) (29.7 (+/-3.9) vs. 35.6 (+/-3.8) p < 0.001). The verbal memory test showed improvement in the walking and E-health groups."},{"id":"source_21","type":"source","study":"Exercise Effects on Cognition in Older African Americans: A Pilot Randomized Trial","year":2022,"doi":"10.3389/fnagi.2022.921978","url":"https://doi.org/10.3389/fnagi.2022.921978","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Gwizdala 2022","excerpt":"INTRODUCTION: Regular physical activity lowers risk for cognitive decline and neurodegenerative disorders. Older African Americans (AAs) have been underrepresented in trials that increased physical activity to improve cognitive outcomes. METHODS: 56 sedentary, older, cognitively healthy AAs (avg. 69.2 ± 3.4 yrs. old) were randomized in 1:1 ratio into either a 12-week successful aging group (SAG) or a 12-week physical activity group (PAG). Participants in SAG attended weekly 60-min educational sessions in which healthy aging topics were discussed. Participants in PAG attended supervised physical activity sessions twice per week at local YMCAs (90-120 min/week) and were prescribed 2-3 days per week of home-based activity. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) assessed cognitive function. ANCOVA models compared mean 12-week change in global cognition and subdomain scores between groups with secondary analyses for sex differences. Effect sizes for RBANS were calculated. RESULTS: The RBANS global cognition score (SAG Est. 5.6 ± 1.8, effect size = 0.37, p = 0.003) and several subdomain scores (one-sample T tests, all p < 0."},{"id":"source_22","type":"source","study":"Meta-analysis of the effects of dance- and movement-based kinesthetic games on cognitive function in older adults with cognitive impairment (CI) under different intervention periods","year":2025,"doi":"10.1007/s40520-025-03233-y","url":"https://doi.org/10.1007/s40520-025-03233-y","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Zhang 2025","excerpt":"OBJECTIVE: To evaluate the effects of different types and durations of exergame interventions on cognition in elderly individuals with cognitive impairment (CI) through a meta-analysis. METHODS: A computerized search was conducted in databases including Cochrane Library, PubMed, Web of Science, Embase, and CNKI from database inception to September 2025. Quality assessment and data extraction were performed on the included studies. Results measures included the MoCA , MMSE, etc. The study designs were randomized controlled trials or qua-si-experimental studies. The Cochrane Handbook's risk of bias tool was used for quality assessment, and Rev Man 5.0 software was employed to conduct meta-analyses on the ef-fects of dance-based and movement-based exergames on cognitive function in elderly CI patients. RESULTS: A total of 13 studies involving 433 CI patients were included. Analysis of the 13 studies showed that dance-based exergaming was significantly superior to exercise-based exergaming in cognitive ability (SMD = 0.73, P < 0.01); interventions lasting ≥8 weeks were more effective than those lasting <8 weeks (SMD = 1.01, P = 0.02)."},{"id":"source_23","type":"source","study":"EFFECTS OF HIGHER- AND LOWER-INTENSITY EXERCISE ON FITNESS, COGNITION, MOTOR FUNCTION, AND QUALITY OF LIFE IN ADULTS WITH TRAUMATIC BRAIN INJURY","year":2025,"doi":"10.2340/jrm-cc.v8.44345","url":"https://doi.org/10.2340/jrm-cc.v8.44345","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Soliman 2025","excerpt":"OBJECTIVE: To assess the effects of higher-intensity aerobic training (AET) and lower-intensity rapid-resisted exercise training (RET) on fitness, cognition, balance, mobility, and quality of life in sedentary adults with chronic traumatic brain injury. DESIGN: Participants were randomized to AET, RET, or waitlist control later randomized to AET or RET. PARTICIPANTS: Nine adults, 25 to 65 years, completed elliptical training (AET = 4; RET = 5). Follow-up data were available for 4 AET and 2 RET. METHODS: Exercise groups trained for 12 weeks. Outcomes were assessed at 0, 12, and 24 weeks. RESULTS: Main effects from exercise included improvements in the Brief Visuospatial Memory Test, Limits of Stability excursion, fast elliptical cadence, and self-reported cognitive abilities. Improved fitness was related strongly to improved memory, balance, and quality of life. Similar fitness gains across groups indicate high individual variability in response to exercise intensity. Continuing to exercise during follow-up was associated with more cognitive benefits."},{"id":"source_24","type":"source","study":"Effects of Physical Exercise on Cognition and Telomere Length in Healthy Older Women","year":2021,"doi":"10.3390/brainsci11111417","url":"https://doi.org/10.3390/brainsci11111417","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Sanchez-Gonzalez 2021","excerpt":"BACKGROUND: Physical exercise is an effective measure for preventing the onset of cognitive decline and has a direct influence on the aging process. The purpose of this study was to assess the effect of a 6-month physical exercise program on cognition and telomere length in adults over 65 years of age. METHOD: Seventy-four healthy women were separated into two groups: 41 were included in the intervention group (IG) (72.70 ± 4.127 years and 8.18 ± 1.551 years of education) and 33 in the control group (CG) (71.21 ± 4.127 years and 8.42 ± 2.562). The participants included within the IG carried out three sessions of physical exercise per week for six months. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Stroop test and the Trail Making Test (TMT). Saliva samples were taken and analyzed and relative telomere length was calculated. Those conducting the analysis were blind to the group to which the participants had been assigned. RESULTS: An improvement was observed in global cognitive function, in both attentional and executive functions, in the group of adults doing physical exercise as compared to the control group."},{"id":"source_25","type":"source","study":"Physical Exercise and Brain Health: Exploring Activity Types to Enhance Cognition in Older Adults","year":2025,"doi":"10.1093/geroni/igaf122.2748","url":"https://doi.org/10.1093/geroni/igaf122.2748","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Egbert 2025","excerpt":"This study aimed to examine the relationship between perceived cognitive difficulties (assessed via the Patient Assessment of Own Functioning Inventory-PAOFI), various forms of physical activity (walking, light, moderate, strenuous, and strength/endurance exercises), and sedentary behavior in a sample of adults aged 60-80 years (n = 42). Higher scores on PAOFI Memory Scale were linked to male sex (B=-4.591, p=.003, CI95%=-7.518, -1.665), Caucasian White race/ethnicity (B = 12.538, p=.006, CI95%=3.961, 21.116), and engaging in more physical activities of light (B = 2.982, p=.006, CI95%=.905, 5.058) and moderate intensity (B = 14.093, p=.004, CI95%=4.736, 23.451)."},{"id":"source_26","type":"source","study":"Effects of Chronic Physical Exercise or Multicomponent Exercise Programs on the Mental Health and Cognition of Older Adults Living in a Nursing Home: A Systematic Review of Studies From the Past 10 Years","year":2022,"doi":"10.3389/fpsyg.2022.888851","url":"https://doi.org/10.3389/fpsyg.2022.888851","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Silva 2022","excerpt":"Some nursing homes for the elderly provide holistic care that integrates several interventions, including physical exercise. The aim of this systematic review is to summarize the effects of physical exercise or multicomponent exercise programs on the mental health (wellbeing, anxiety and depression) and cognitive functions of older adults with/without dementia who live in a nursing home and do/do not require wheelchair assistance. To this end, PubMed, PsycInfo and Web of Science are using to identify clinical trials and randomized controlled studies conducted during the period January 2011 to December 2021 to examine the progression of research in this field over the past ten years. In total, 2597 articles are identifying and 21 are including in the systematic review. After selecting articles according to the PRISMA standards, the data extraction and methodological quality assessment of the eligible studies are performing individually by two reviewers and then pooled together. The synthesis of the studies shows that physical exercise or multicomponent exercise programs have a beneficial effect on mental health and cognitive functions."},{"id":"source_27","type":"source","study":"The Family Function and Exercise Behavior of Chinese College Students: A Moderated Mediation Model of Exercise Value Cognition and Only-Child Status","year":2021,"doi":"10.3389/fpsyg.2021.644742","url":"https://doi.org/10.3389/fpsyg.2021.644742","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Wu 2021","excerpt":"The purpose of this study is to investigate the mediating role of exercise value cognition between family function (FF) and exercise behavior and the moderating role of an only-child status. A questionnaire survey was conducted on 504 Chinese college students using the FF scale, the exercise value cognition scale, and the exercise behavior scale. The analysis yielded four main findings. (1) There are significant differences between an only-child and a non-only-child for negative exercise behavior and FF. The only-child group has a higher average FF score and a lower average negative exercise score. (2) Exercise behavior and four of its dimensions-exercise autonomy, attention control, exercise planning, and situational induction-are each significantly positively correlated with FF and exercise value cognition. (3) FF is a significantly positive predictor of exercise behavior, both directly and through exercise value cognition, which plays a partial mediating role. (4) Only-child status significantly moderates the mediating effect of exercise value cognition in the link between FF and exercise behavior."},{"id":"source_28","type":"source","study":"Acute Skeletal Muscle Activation Through Physical Exercise and Its Effects on Cognitive Performance and Neurobiological Markers in Adults: A Scoping Review","year":2026,"doi":"10.3390/muscles5020025","url":"https://doi.org/10.3390/muscles5020025","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Brookman-May 2026","excerpt":"Physical exercise can influence cognitive performance and neurobiological processes, but evidence spans diverse modalities, intensities, and adult populations. Acute exercise represents a state of transient skeletal muscle activation that induces systemic signaling through metabolic, endocrine, and myokine-mediated pathways, which may contribute to neurocognitive modulation. To map the breadth of acute exercise-cognition research, characterize cognitive and biological outcomes, and identify consistent patterns and gaps. Studies of adults (≥18 years) involving a single exercise session or short microcycle (≤7 days) with pre-post assessment of cognition and/or neurobiological markers across any exercise modality (aerobic, resistance, high-intensity interval training/HIIT, combined, vibration, mind-body) were included. PubMed and CENTRAL were systematically searched, yielding 101 studies. Data were extracted using a structured framework capturing exercise modality, dose, cognitive domains, biomarkers, neuroimaging outcomes, population characteristics, and study design features. Most studies examined young adults (53%) or older adults (32%)."},{"id":"source_29","type":"source","study":"Effect of preoperative cognitive and physical optimization in the prevention of postoperative cognitive deficit in elderly patients with lung resection – cognition trial","year":2025,"doi":"10.1186/s13063-025-08894-8","url":"https://doi.org/10.1186/s13063-025-08894-8","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Neskovic 2025","excerpt":"BACKGROUND: Postoperative cognitive dysfunction (POCD) can develop from 7 days to 1 year after surgery. It is a long-lasting disorder that affects various cognitive domains, including memory, executive function, attention, verbal fluency, and visuospatial performance. Mild symptoms are often overlooked or misinterpreted as signs of normal ageing. The impact of POCD on recovery and quality of life after surgery is not fully understood. This study aims to assess the effects of preoperative cognitive and physical training on postoperative cognitive outcomes and recovery in elderly patients undergoing lung resection. METHODS: Patients who meet the inclusion criteria, after signing the informed consent, are randomized into: (1) The Intervention group: patients receive preoperative cognitive stimulation and physical training from the inclusion until scheduled surgery. (2) The Control group: patients receive standard treatment. Patients from the Intervention group will be assessed for cognitive status and subjected to structured cognitive training at least three times a week for a minimum of 20 min (from the moment of study inclusion, until surgery, targeting 1 month)."},{"id":"source_30","type":"source","study":"EFFECTS OF HIGH-INTENSITY AQUATIC EXERCISE ON INFLAMMATION AND COGNITION IN OLDER ADULTS WITH MCI","year":2023,"doi":"10.1093/geroni/igad104.3293","url":"https://doi.org/10.1093/geroni/igad104.3293","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Louras 2023","excerpt":"A secondary data analysis was conducted on 20 healthy volunteers (mean age 68.2 ±7.75 years) who participated in 6 months of supervised aquatic exercise training. Specifically, decreased EN-RAGE concentrations resulted in significantly improved delayed verbal memory scores (parameter estimate= -0.893, p= .023), while increased IL-20RA concentrations led to better task completion (parameter estimate= 2.145, p= .030)."},{"id":"source_31","type":"source","study":"Nature-based and technology-assisted exercise for cognitive and mobility outcomes in older adults: a systematic review of randomized trials","year":2026,"doi":"10.1186/s12877-026-06978-x","url":"https://doi.org/10.1186/s12877-026-06978-x","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Jia 2026","excerpt":"BACKGROUND: Population aging and rising rates of mild cognitive impairment and mood symptoms have intensified interest in low-cost strategies to preserve brain health and independence. Physical activity is an established protective factor, but adherence to exercise programs remains suboptimal. Emerging work suggests that the exercise environment, including natural settings and immersive or interactive formats, may confer benefits beyond conventional indoor training. METHODS: We systematically searched major electronic databases for randomized trials in older adults that compared nature-based or outdoor exercise, or immersive and interactive modalities (virtual reality or exergaming), with broadly dose-matched indoor or usual-exercise control conditions. Eligible studies enrolled older participants or reported stratified results for those aged at least 60 years or with mild cognitive impairment. Primary outcomes were brain-related measures spanning executive function and global cognition, mood and perceived restoration, dual-task gait, autonomic and endocrine stress markers, and indices of brain activation or connectivity."},{"id":"source_32","type":"source","study":"The effect of physical exercise and cognition-orientated interventions on post-stroke cognitive function: Protocol for an overview of reviews","year":2025,"doi":"10.1371/journal.pone.0318567","url":"https://doi.org/10.1371/journal.pone.0318567","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"protocol","cited_as":"Smith 2025","excerpt":"BACKGROUND: Strokes are becoming more common, and with improving survival rates, the prevalence of stroke survivors has increased. Almost half of chronic stroke survivors are cognitively impaired, and healthcare services are struggling to manage these patients, leaving some feeling \"abandoned\". Several systematic reviews have investigated the effect of physical exercise and cognition-orientated interventions on post-stroke cognitive impairment, and have produced conflicting findings, making it difficult for clinicians and guideline producers to make evidence-based decisions. This overview of reviews aims to provide a comprehensive overview of systematic reviews investigating the effect of physical exercise and cognition-orientated interventions on post-stroke cognitive function, assess methodological quality and certainty of evidence, and identify sources of discordance between these reviews. METHODS: Eight databases-Embase, Medline, CINAHL, Psycinfo, SPORTDiscus, The Cochrane Database of Systematic reviews, Epistemonikos, and Scopus-plus grey literature sources will be searched."},{"id":"source_33","type":"source","study":"EFFECTS OF HOME-BASED COGNITIVE AND PHYSICAL EXERCISE TRAINING ON COGNITION IN OLDER ADULTS: THE COVEPIC TRIAL","year":2024,"doi":"10.1093/geroni/igae098.2186","url":"https://doi.org/10.1093/geroni/igae098.2186","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Bherer 2024","excerpt":"This randomized clinical trial (COVEPIC study) aimed to compare the effects of 6 months of home-based physical exercise alone and combined with cognitive training on the cognition of older adults. 127 adults (50 years and older) were randomly assigned to one of the two following intervention arms (1:1): 1/ home-based physical exercise alone or 2/ combined home-based physical exercise and cognitive training."},{"id":"source_34","type":"source","study":"Effects of exercise interventions on cognition, physical function and quality of life among older adults with cognitive frailty: A systematic review and meta-analysis.","year":2025,"doi":"10.1016/j.gerinurse.2025.01.006","url":"https://doi.org/10.1016/j.gerinurse.2025.01.006","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yuan 2025","excerpt":"OBJECTIVES: To explore the effects of exercise interventions on cognition, physical function, and quality of life among older adults with cognitive frailty. METHODS: A systematic review and meta-analysis were conducted (PROSPERO [CRD42024532608]). PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang, VIP, and SinoMed databases were searched from inception until December 18, 2023. RESULTS: We found exercise improved overall cognition, physical frailty, walking ability, gait speed, and so on among older adults with cognitive frailty, but the effect on physical fitness and quality of life was insignificant. Subgroup analysis revealed exercise conducted ≥3 times per week, each session lasting ≤45 min and cycle≤12 weeks, had better-improved cognition. Traditional mind-body exercises like Baduanjin were more effective than resistance training for enhancing cognition. CONCLUSIONS: Exercise intervention benefits overall cognition and most physical functions, but its impact on physical fitness and quality of life remains to be confirmed by future studies."},{"id":"source_35","type":"source","study":"Physical exercise and cognition in older adults, a scientific approach scanty reported in Latin America and Caribbean populations","year":2024,"doi":"10.3389/fspor.2024.1368593","url":"https://doi.org/10.3389/fspor.2024.1368593","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Jimenez-Maldonado 2024","excerpt":"The advancement of public services, including the increased accessibility of health services, has led to a rise in life expectancy globally. As a result, aging populations are becoming more prevalent, raising concerns about cognitive decline. Fortunately, non-pharmacological methods, such as physical exercise, have been shown to mitigate the effects of aging on the brain. In this perspective article, we examined meta-analyses on the impact of physical exercise on cognition in older adults. The results indicate that combined exercise (i.e., aerobic plus strength training), has a significant positive effect on overall cognition and executive function. However, we found a lack of scientific studies on this topic in Latin American and Caribbean countries. Therefore, there is a pressing need for research to identify the feasibility of physical exercise interventions to improve cognitive skills in older adults from these regions."},{"id":"source_36","type":"source","study":"Impact of Diet and Exercise Interventions on Cognition and Brain Health in Older Adults: A Narrative Review","year":2023,"doi":"10.3390/nu15112495","url":"https://doi.org/10.3390/nu15112495","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Key 2023","excerpt":"The ability to preserve cognitive function and protect brain structure from the effects of the aging process and neurodegenerative disease is the goal of non-pharmacologic, lifestyle interventions focused on brain health. This review examines, in turn, current diet and exercise intervention trends and the collective progress made toward understanding their impact on cognition and brain health. The diets covered in this review include the Mediterranean diet (MeDi), Dietary Approaches to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), ketogenic diet, intermittent fasting, and weight loss management. The exercise approaches covered in this review include endurance, resistance, combined exercise programs, yoga, tai chi, and high-intensity interval training. Although valuable evidence is building concerning how diet and exercise influence cognitive performance and brain structure, many of the open questions in the field are concerned with why we see these effects. Therefore, more strategically designed intervention studies are needed to reveal the likely multiple mechanisms of action in humans."},{"id":"source_37","type":"source","study":"Effects of Exercise on Cognitive Performance in Older Adults: A Narrative Review of the Evidence, Possible Biological Mechanisms, and Recommendations for Exercise Prescription","year":2020,"doi":"10.1155/2020/1407896","url":"https://doi.org/10.1155/2020/1407896","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Quigley 2020","excerpt":"Physical activity and exercise have emerged as potential methods to improve brain health among older adults. However, there are currently no physical activity guidelines aimed at improving cognitive function, and the mechanisms underlying these cognitive benefits are poorly understood. The purpose of this narrative review is to present the current evidence regarding the effects of physical activity and exercise on cognition in older adults without cognitive impairment, identify potential mechanisms underlying these effects, and make recommendations for exercise prescription to enhance cognitive performance. The review begins with a summary of evidence of the effect of chronic physical activity and exercise on cognition. Attention then turns to four main biological mechanisms that appear to underlie exercise-induced cognitive improvement, including the upregulation of growth factors and neuroplasticity, inhibition of inflammatory biomarker production, improved vascular function, and hypothalamic-pituitary-adrenal axis regulation."},{"id":"source_38","type":"source","study":"Evidence-Based Exercise Interventions and Fitness Technologies for Older Adults With Intact or Impaired Cognition","year":2020,"doi":"10.1093/geroni/igaa057.3115","url":"https://doi.org/10.1093/geroni/igaa057.3115","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Heyn 2020","excerpt":"One of the presentations in this symposium, will highlight the research that has been evaluating for the last 15 years the effectiveness of the exercise randomized trial for older adults with/out cognitive impairments."},{"id":"source_39","type":"source","study":"The Impact of Blood Pressure Dipping Status on Cognition, Mobility, and Cardiovascular Health in Older Adults Following an Exercise Program","year":2018,"doi":"10.1177/2333721418770333","url":"https://doi.org/10.1177/2333721418770333","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Silva 2018","excerpt":"Objectives: To determine whether a dual-task gait and aerobic exercise intervention differentially impacted older adults with normal blood pressure (BP) dipping status (dippers) compared to those with nondipping status (nondippers). Methods: This study was a secondary analysis involving participants (mean age = 70.3 years, 61% women) who attended a laboratory-based exercise intervention over a 6-month period (40 min/day and 3 days/week). Participants were assessed in measures of cognition, mobility, and cardiovascular health at baseline, 3, 6, and 12 months (after a 6-month no-contact follow-up). Results: We observed improvements in cognition in both groups at 6 and 12 months, although no between-group differences were seen. Nondippers demonstrated superior improvements in usual gait velocity and step length after the exercise intervention compared to dippers. Dippers reduced daytime systolic BP at 6 and 12 months to a greater extent than nondippers. Discussion: BP dipping status at baseline did not influence exercise benefits to cognition but did mediate changes in mobility and cardiovascular health."},{"id":"source_40","type":"source","study":"Multicomponent Exercise on Physical Function, Cognition and Hemodynamic Parameters of Community-Dwelling Older Adults: A Quasi-Experimental Study","year":2019,"doi":"10.3390/ijerph16122184","url":"https://doi.org/10.3390/ijerph16122184","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Goncalves 2019","excerpt":"This paper reports on a quasi-experimental study that aimed to identify changes in muscle function (i.e., mobility, maximal walking speed, lower limb muscle strength, balance, and transfer capacity), cognition (i.e., executive function) and hemodynamic parameters of community-dwelling Brazilian older adults during a six-month multicomponent exercise program (MCEP). A total of 436 community-dwelling older adults performed functional, cognitive and hemodynamic assessments before and after a six-month MCEP. The program of exercise was performed twice a week over 26 weeks at moderate intensity. Results indicate that balance, mobility (i.e., usual and maximal walking speeds) and transfer capacity ( p < 0.05) were significantly improved after the MCEP. Moreover, all hemodynamic parameters (i.e., systolic, diastolic and mean arterial pressures), except for heart rate ( p > 0.05), were significantly reduced after the intervention. The current findings indicate that a six-month MCEP may provide physical and hemodynamic benefits in community-dwelling older adults. Nevertheless, our findings need to be confirmed in larger samples and better designed studies."},{"id":"source_41","type":"source","study":"Effect of Exercise on Cognition, Conditioning, Muscle Endurance, and Balance in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial","year":2019,"doi":"10.1519/jpt.0000000000000191","url":"https://doi.org/10.1519/jpt.0000000000000191","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Langoni 2019","excerpt":"BACKGROUND AND PURPOSE: Mild cognitive impairment (MCI) may be a precursor to dementia; however, its progression may be prevented or slowed with exercise. This study aimed at determining the effects of group aerobic and strength training on cognition, conditioning, muscle endurance, and balance in underprivileged community-dwelling older adults with MCI. METHODS: This was a single-blind, randomized, and matched-pair controlled (gender, age, body mass index, and Addenbrooke's Cognitive Examination-Revised for MCI diagnosis) clinical trial. It was developed in 4 community centers. Fifty-two sedentary, functionally independent individuals, aged 60 years or more, with MCI were randomized into intervention group (n = 26) and control group (n = 26). Participants were tested before and after a 24-week exercise program. Sociodemographic characteristics, cognition (Mini-Mental State Examination), conditioning (2-minute stationary walk test), lower-limb endurance (30-second sit/stand test), and balance data (Functional Reach test) were collected. The intervention group walked and exercised twice weekly (60 minutes each) using ankle weights, latex resistance bands, and dumbbells."}],"edges":[{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_1","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_2","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_3","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_4","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_5","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_6","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_7","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_8","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_9","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_10","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_11","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_12","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_13","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_14","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_15","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_16","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_17","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_18","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_19","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_20","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_21","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_22","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_23","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_24","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_25","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_26","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_27","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_28","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_29","type":"contains_claim"},{"from":"67cf5fb4-7f00-4a8d-a4d3-c4dec0ac54b5","to":"claim_30","type":"contains_claim"}],"screening":{"identified":41,"screened":41,"excluded":0,"included":41,"included_or_retained":41,"flow":["identified","screened","excluded_with_reasons","included"],"wording":"41 candidate receipts retained after source retrieval, deduplication, and topic filtering. 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