Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment
Open accessAbstract
BACKGROUND: Physical activity is beneficial for healthy ageing. It may also help maintain good cognitive function in older age. Aerobic activity improves cardiovascular fitness, but it is not known whether this sort of fitness is necessary for improved cognitive function. Studies in which activity, fitness and cognition are reported in the same individuals could help to resolve this question. OBJECTIVES: To assess the effectiveness of physical activity, aimed at improving cardiorespiratory fitness, on cognitive function in older people without known cognitive impairment. SEARCH STRATEGY: We searched MEDLINE, EMBASE, PEDro, SPORTDiscus, PsycINFO, CINAHL, Cochrane Controlled Trials Register (CENTRAL), Dissertation abstracts international and ongoing trials registers on 15 December 2005 with no language restrictions. SELECTION CRITERIA: All published randomised controlled trials comparing aerobic physical activity programmes with any other intervention or no intervention with participants older than 55 years of age were eligible for inclusion. DATA COLLECTION AND ANALYSIS: Eleven RCTs fulfilling the inclusion criteria are included in this review. Two reviewers independently extracted the data from these included studies. MAIN RESULTS: Eight out of 11 studies reported that aerobic exercise interventions resulted in increased cardiorespiratory fitness of the intervention group (an improvement on the maximum oxygen uptake test which is considered to be the single best indicator of the cardiorespiratory system) of approximately 14% and this improvement coincided with improvements in cognitive capacity. The largest effects on cognitive function were found on motor function and auditory attention (effect sizes of 1.17 and 0.50 respectively). Moderate effects were observed for cognitive speed (speed at which information is processed; effect size 0.26) and visual attention (effect size 0.26). AUTHORS' CONCLUSIONS: There is evidence that aerobic physical activities which improve cardiorespiratory fitness are beneficial for cognitive function in healthy older adults, with effects observed for motor function, cognitive speed, auditory and visual attention. However, the majority of comparisons yielded no significant results. The data are insufficient to show that the improvements in cognitive function which can be attributed to physical exercise are due to improvements in cardiovascular fitness, although the temporal association suggests that this might be the case. Larger studies are still required to confirm whether the aerobic training component is necessary, or whether the same can be achieved with any type of physical exercise. At the same time, it would be informative to understand why some cognitive functions seem to improve with (aerobic) physical exercise while other functions seem to be insensitive to physical exercise. Clinicians and scientists in the field of neuropsychology should seek mutual agreement on a smaller battery of cognitive tests to use, in order to render research on cognition clinically relevant and transparent and heighten the reproducibility of results for future research.
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In older adults with below-median respiratory capacity, aerobic exercise that raises respiratory capacity also improves cognitive performance.
“Many controlled studies in elderly individuals have demonstrated that, in individuals with below median respiratory capacity, aerobic exercise that increases this respiratory capacity also results in increases in cognitive performance47, 48.”
From Cognitive reserve in ageing and Alzheimer's disease (2012) · cites this paper as [47]
The Discussion reports that eight of 11 studies found increased cardiorespiratory fitness after aerobic exercise, coinciding with improvements in some cognitive functions. The Authors’ conclusions say the evidence is insufficient to show that improved fitness caused the cognitive gains. The passages do not establish the claim specifically for older adults with below-median respiratory capacity. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAerobic exercise has been the most effective remediation approach so far.
“The most successful remediation approach to date has been aerobic exercise.”
From Cognitive reserve in ageing and Alzheimer's disease (2012) · cites this paper as [47]
The Authors’ conclusions report that aerobic activity can benefit some cognitive functions in healthy older adults. They also say most comparisons were not significant and that it remains unclear whether aerobic training is necessary, so the review does not establish it as the most successful remediation approach. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSeveral meta-analyses have reported modest positive effect sizes for the exercise-cognition relationship.
“Several meta-analyses100–102 have reported modest positive effect sizes for the exercise-cognition relationship.”
From Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association (2017) · cites this paper as [100]
Increasing physical activity improves serum lipid levels.
“Increasing physical activity maintains or adds to physical fitness, improves serum lipid levels, decreases blood pressure, increases insulin sensitivity and glucose tolerance, improves vascular endothelial function, and decreases thrombosis risk591–593).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [593]
Increasing physical activity decreases blood pressure.
“Increasing physical activity maintains or adds to physical fitness, improves serum lipid levels, decreases blood pressure, increases insulin sensitivity and glucose tolerance, improves vascular endothelial function, and decreases thrombosis risk591–593).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [593]
Increasing physical activity increases insulin sensitivity and glucose tolerance.
“Increasing physical activity maintains or adds to physical fitness, improves serum lipid levels, decreases blood pressure, increases insulin sensitivity and glucose tolerance, improves vascular endothelial function, and decreases thrombosis risk591–593).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [593]
Increasing physical activity improves vascular endothelial function.
“Increasing physical activity maintains or adds to physical fitness, improves serum lipid levels, decreases blood pressure, increases insulin sensitivity and glucose tolerance, improves vascular endothelial function, and decreases thrombosis risk591–593).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [593]
Increasing physical activity decreases thrombosis risk.
“Increasing physical activity maintains or adds to physical fitness, improves serum lipid levels, decreases blood pressure, increases insulin sensitivity and glucose tolerance, improves vascular endothelial function, and decreases thrombosis risk591–593).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [593]
Inconsistencies in randomized controlled trial findings may partially be explained by methodological variation between trials, making it difficult to systematically compare their findings in meta-analyses.
“Such inconsistencies may partially be explained by the methodological variation between RCTs, making it difficult to systematically compare their findings in meta-analyses (Angevaren et al., 2008; Young et al., 2015).”
From Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment (2016) · cites this paper as Angevaren et al., 2008
Meta-analyses have found aerobic exercise interventions improve cognitive performance mostly in older age groups.
“Meta-analyses have found AE interventions to improve cognitive performance across a variety of domains, including attention, executive functioning, processing speed, motor functioning, and memory in healthy young and middle aged adults (Etnier et al., 1997; Smith et al., 2010; Chang et al., 2012;”
From Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment (2016) · cites this paper as Angevaren et al., 2008
Aerobic training improves cognitive function in individuals with Parkinson's disease, including working memory and verbal fluency.
“Similarly, Cruise and colleagues showed cognitive improvement in individuals with PD, including working memory and verbal fluency with aerobic training 68–70.”
From Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease (2013) · cites this paper as [70]
Studies in healthy rodents subjected to different exercise paradigms have demonstrated experience-dependent increases in dendritic spine density in regions including the hippocampus and cerebellum.
“While an important question in exercise yet to be fully addressed in PD and its animal models, studies in healthy rodents subjected to different exercise paradigms have demonstrated experience-dependent increases in dendritic spine density in a number of regions including the hippocampus and cerebellum 70, 94.”
From Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson's disease (2013) · cites this paper as [70]
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“…2010; Chang et al., 2012; Roig et al., 2013; Verburgh et al., 2013) but mostly in older age groups (Etnier et al., 1997; Colcombe and Kramer, 2003; Angevaren et al., 2008; van Uffelen et al., 2008; Smith et al., 2010; Snowden et al., 2011; Chang et al., 2012), as well as in older individuals with…”
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The History of Research on Chronic Physical Activity and Cognitive Performance
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- Authors
- Angevaren, M., Aufdemkampe, G., Verhaar, H., Aleman, A., & Vanhees, L.
- Affiliations
- University of Applied Sciences Utrecht (NL)
- Utrecht University (NL)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- John Wiley & Sons, Ltd
- Published
- 2008-07-16
- Issue
- 3
- Pages
- CD005381-CD005381
- ISSN
- 1361-6137 (ISSN-L)
- OpenAlex
- W2099899980
- Cited by
- 1,130
- References
- 78
- Citations by year
- 2026: 7 · 2025: 30 · 2024: 33 · 2023: 44 · 2022: 58 · 2021: 52 · 2020: 60 · 2019: 62 · 2018: 59 · 2017: 85 · 2016: 71 · 2015: 117 · 2014: 99 · 2013: 75 · 2012: 94
- Type
- reference entry
- Language
- en
- Update notices
- new_version (2015-04-22)
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion, other-oa)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- aerobic exercise, cardiorespiratory fitness, cognitive function, older adults, healthy aging, VO2max, motor function, auditory attention, visual attention, cognitive speed, exercise intervention, cognitive impairment prevention, physical activity interventions, neuropsychology, healthy lifestyle intervention, healthy lifestyle promotion
- MeSH terms
- Aged, Cognition, Cognition Disorders, Humans, Memory, Middle Aged, Oxygen Consumption, Physical Fitness, Exercise, Randomized Controlled Trials as Topic
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