Aerobic exercise to improve cognitive function in older people without known cognitive impairment
Open accessAbstract
BACKGROUND: There is increasing evidence that physical activity supports healthy ageing. Exercise is helpful for cardiovascular, respiratory and musculoskeletal systems, among others. Aerobic activity, in particular, improves cardiovascular fitness and, based on recently reported findings, may also have beneficial effects on cognition among older people. OBJECTIVES: To assess the effect of aerobic physical activity, aimed at improving cardiorespiratory fitness, on cognitive function in older people without known cognitive impairment. SEARCH METHODS: We searched ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialized Register, the Cochrane Controlled Trials Register (CENTRAL) (all years to Issue 2 of 4, 2013), MEDLINE (Ovid SP 1946 to August 2013), EMBASE (Ovid SP 1974 to August 2013), PEDro, SPORTDiscus, Web of Science, PsycINFO (Ovid SP 1806 to August 2013), CINAHL (all dates to August 2013), LILACS (all dates to August 2013), World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch), ClinicalTrials.gov (https://clinicaltrials.gov) and Dissertation Abstracts International (DAI) up to 24 August 2013, with no language restrictions. SELECTION CRITERIA: We included all published randomised controlled trials (RCTs) comparing the effect on cognitive function of aerobic physical activity programmes with any other active intervention, or no intervention, in cognitively healthy participants aged over 55 years. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted the data from included trials. We grouped cognitive outcome measures into eleven categories covering attention, memory, perception, executive functions, cognitive inhibition, cognitive speed and motor function. We used the mean difference (or standardised mean difference) between groups as the measure of the treatment effect and synthesised data using a random-effects model. We conducted separate analyses to compare aerobic exercise interventions with no intervention and with other exercise, social or cognitive interventions. Also, we performed analyses including only trials in which an increase in the cardiovascular fitness of participants had been demonstrated. MAIN RESULTS: Twelve trials including 754 participants met our inclusion criteria. Trials were from eight to 26 weeks in duration.We judged all trials to be at moderate or high risk of bias in at least some domains. Reporting of some risk of bias domains was poor.Our analyses comparing aerobic exercise to any active intervention showed no evidence of benefit from aerobic exercise in any cognitive domain. This was also true of our analyses comparing aerobic exercise to no intervention. Analysing only the subgroup of trials in which cardiorespiratory fitness improved in the aerobic exercise group showed that this improvement did not coincide with improvements in any cognitive domains assessed. Our subgroup analyses of aerobic exercise versus flexibility or balance interventions also showed no benefit of aerobic exercise in any cognitive domain.Dropout rates did not differ between aerobic exercise and control groups. No trial reported on adverse effects.Overall none of our analyses showed a cognitive benefit from aerobic exercise even when the intervention was shown to lead to improved cardiorespiratory fitness. AUTHORS' CONCLUSIONS: We found no evidence in the available data from RCTs that aerobic physical activities, including those which successfully improve cardiorespiratory fitness, have any cognitive benefit in cognitively healthy older adults. Larger studies examining possible moderators are needed to confirm whether or not aerobic training improves cognition.
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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 [592]
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 [592]
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 [592]
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 [592]
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 Young et al., 2015
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- METS.mp. 650 Aerobic exercise to improve cognitive function in older people without known cognitive impairment (Review) Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 17. Watts.mp. 18. treadmill speed.mp. 19. inclination.mp. 20. Adult/ or adult*.mp. 21. middle aged.mp. or Middle Aged/ 22. aged.mp. or Aged/ 23. elderly.mp. 24. old*.mp. 25. geriatric.mp. or Geriatrics/ 26. 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 27. 13 or 14 or 15 or 16 or 17 or 18 or 19 28. 20 or 21 or 22 or 23 or 24 or 25 29. 26 and 27 and 28
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“This result is particularly relevant given the growing recognition of the importance of lifestyle during middle age for lifelong cognitive health (Wilson et al., 2002; Karp et al., 2006; Young et al., 2015).”
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“Some RCTs have stipulated that AE influences divergent cognitive domains, whereas others have suggested AE had no significant impact on cognition at all (Etnier et al., 2006; van Uffelen et al., 2008; Snowden et al., 2011; Gates et al., 2013; Kelly et al., 2014; Young et al., 2015).”
An umbrella review of randomized control trials on the effects of physical exercise on cognition
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“While exercise interventions have demonstrated benefits to cognitive function in older adults [3,6–10], a recent Cochrane review published in 2015 suggested there was insufficient evidence from randomized controlled trials (RCTs) to conclude such a benefit [11].”
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Gray, M., Madero, E. N., Gills, J. L., Paulson, S., Jones, M. D., Campitelli, A., Myers, J., Bott, N. T., & Glenn, J. M. (2022) · JMIR Research Protocols · doi:10.2196/31841 · Cited by 15 · see citing works
- Authors
- Young, J., Angevaren, M., Rusted, J., & Tabet, N.
- Affiliations
- University of Sussex (GB)
- University of Applied Sciences Utrecht (NL)
- Brighton and Sussex Medical School (GB)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2015-04-22
- Volume
- 2015
- Issue
- 4
- Pages
- CD005381-CD005381
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC10554155
- OpenAlex
- W1614035160
- Cited by
- 505
- References
- 144
- Citations by year
- 2026: 13 · 2025: 20 · 2024: 37 · 2023: 48 · 2022: 38 · 2021: 54 · 2020: 53 · 2019: 66 · 2018: 64 · 2017: 63 · 2016: 30 · 2015: 19
- FWCI
- 7.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (13/89/22)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Keywords
- aerobic exercise, cognitive function, older adults, healthy aging, cardiorespiratory fitness, physical activity, memory, executive function, attention, cognitive speed, motor function, cognitive inhibition, cognitive intervention, exercise intervention, risk of bias, trial reporting quality, dementia prevention, cognitive impairment prevention, exercise duration, exercise frequency
- MeSH terms
- Aged, Cognition, Cognition Disorders, Humans, Memory, Middle Aged, Oxygen Consumption, Physical Fitness, Exercise, Randomized Controlled Trials as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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