Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials
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Abstract
Combining physical exercise with cognitive training is a popular intervention in dementia prevention trials and guidelines. However, it remains unclear what combination strategies are most beneficial for cognitive and physical outcomes. We aimed to compare the efficacy of the three main types of combination strategies (simultaneous, sequential or exergaming) to either intervention alone or control in older adults. Randomized controlled trials of combined cognitive and physical training were included in multivariate and network meta-analyses. In cognitively healthy older adults and mild cognitive impairment, the effect of any combined intervention relative to control was small and statistically significant for overall cognitive (k = 41, Hedges' g = 0.22, 95 % CI 0.14 to 0.30) and physical function (k = 32, g = 0.25, 95 % CI 0.13 to 0.37). Simultaneous training was the most efficacious approach for cognition, followed by sequential combinations and cognitive training alone, and significantly better than physical exercise. For physical outcomes, simultaneous and sequential training showed comparable efficacy as exercise alone and significantly exceeded all other control conditions. Exergaming ranked low for both outcomes. Our findings suggest that simultaneously and sequentially combined interventions are efficacious for promoting cognitive alongside physical health in older adults, and therefore should be preferred over implementation of single-domain training.
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- Smart, C. M.; Karr, J. E.; Areshenkoff, C.; Rabin, L.; Hudon, C.; Ali, J. I.; Arenaza- Urquijo, E. M.; Buckley, R. F.; Chetelat, G.; Gates, N.; Hampel, H.; Jessen, F.; Marchant, N. L.; Sikkes, S. A. M.; Tales, A.; Van Der Flier, W. M.; Wesselman, L. 2016 Impact of non-pharmacologic interventions on cognitive, behavioral, and emotional functioning in older adults with subjective cognitive decline: A systematic review of controlled trials Not RCT
- Smart, C. M.; Karr, J. E.; Areshenkoff, C. N.; Rabin, L. A.; Hudon, C.; Gates, N.; Ali, J. I.; Arenaza-Urquijo, E. M.; Buckley, R. F.; Chetelat, G.; Hampel, H.; Jessen, F.; Marchant, N. L.; Sikkes, S. A. M.; Tales, A.; van der Flier, W. M.; Wesselman, L. 2017 Non-Pharmacologic Interventions for Older Adults with Subjective Cognitive Decline: Systematic Review, Meta- Analysis, and Preliminary Recommendations Not RCT
- Sanders, L. M. J.; Hortobagyi, T.; Gemert, S. L. B. V.; Van Der Zee, E. A.; Van Heuvelen, M. J. G. 2019 Dose-response relationship between exercise and cognitive function in older adults with and without cognitive impairment: A systematic review and meta-analysis Not RCT
- Orellano, E.; Colon, W. I.; Arbesman, M. 2012 Effect of occupation-and activity-based interventions on instrumental activities of daily living performance among community-dwelling older adults: A systematic review Not RCT
- Wayne, P. M.; Walsh, J.; Taylor-Piliae, R.; Wells, R.; Papp, K.; Donovan, N.; Yeh, G. 2014 The impact of Tai-Chi on cognitive performance in older adults: A systematic review and meta-analysis Not RCT
- Wang, S.; Yin, H.; Jia, Y.; Zhao, L.; Wang, L.; Chen, L. 2018 Effects of mind-body exercise on cognitive function in older adults with cognitive impairment: A systematic review and meta- analysis Not RCT
- Zou, L.; Loprinzi, P. D.; Yeung, A. S.; Zeng, N.; Huang, T. 2019 The Beneficial Effects of Mind-Body Exercises for People With Mild Cognitive Impairment: a Systematic Review With Meta- analysis Not RCT
- Vaportzis, E.; Niechcial, M. A.; Gow, A. J. 2019 A systematic literature review and meta-analysis of real-world interventions for cognitive ageing in healthy older adults Not RCT
- Bamidis, P. D.; Vivas, A. B.; Styliadis, C.; Frantzidis, C.; Klados, M.; Schlee, W.; Siountas, A.; Papageorgiou, S. G. 2014 A review of physical and cognitive interventions in aging Not RCT Arlati, S.; Colombo, V.; Spoladore, D.; Greci, L.; Pedroli, E.; Serino, S.; Cipresso, P.; Goulene, K.; Stramba-Badiale, M.; Riva, G.; Gaggioli, A.; Fserrigno, G.; Sacco, M. 2019 A Social Virtual Reality-Based Application for the Physical and Cognitive Training of the Elderly at Home Not RCT
- Antwi, F. A.; Fazylova, N.; Garcon, M. C.; Lopez, L.; Rubiano, R.; Slyer, J. T. 2013 Effectiveness of web-based programs on the reduction of childhood obesity in school-aged children: A systematic review Not RCT
- Scott, I.; Cooper, C.; Leverton, M.; Burton, A.; Beresford-Dent, J.; Rockwood, K.; Butler, L.; Rapaport, P. 2019 Effects of nonpharmacological interventions on functioning of people living with dementia at home: A systematic review of randomised controlled trials Not RCT
- Amoyal, N.; Fallon, E. 2012 Physical exercise and cognitive training clinical interventions used in slowing degeneration associated with mild cognitive impairment: A review of the recent literature Not RCT
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- Authors
- Gavelin, H. M., Dong, C., Minkov, R., Bahar-Fuchs, A., Ellis, K. A., Lautenschlager, N. T., Mellow, M. L., Wade, A. T., Smith, A. E., Finke, C., Krohn, S., & Lampit, A.
- Affiliations
- The University of Melbourne (AU)
- University of South Australia (AU)
- Humboldt-Universität zu Berlin (DE)
- Corresponding author
- Lampit, Amit
- ORCID
- Venue
- Ageing Research Reviews
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 66
- Pages
- 101232
- ISSN
- 1568-1637 (ISSN-L)
- OpenAlex
- W3108507079
- Cited by
- 371
- References
- 104
- Citations by year
- 2026: 68 · 2025: 83 · 2024: 74 · 2023: 62 · 2022: 62 · 2021: 22
- FWCI
- 6.04
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- Ageing Research Reviews (publishedVersion)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UniSA Research Outputs Repository (University of South Australia) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, other-oa)
- Figshare (submittedVersion, cc-by)
- Funders
- University of Melbourne
- National Health and Medical Research Council (GNT1171313)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- older adults, mild cognitive impairment, dementia prevention, simultaneous training, sequential training, exergames, physical activity, cognitive training, physical function, cognitive function
- MeSH terms
- Network Meta-Analysis, Aged, Cognition, Cognition Disorders, Humans, Randomized Controlled Trials as Topic, Cognitive Dysfunction
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