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Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials
Open accessPublished version of a preprint
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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“The Cattell-Horn-Carroll-Miyake Model of Cognition for Clinical Assessment22 was used to categorise the tests.”
From Effectiveness of exercise for improving cognition, memory and executive function: a systematic umbrella review and meta-meta-analysis (2025) · cites this paper as [22]
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1 retracted
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Reuben, D. B., Kremen, S. A., & Maust, D. T. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2023.8522 · Cited by 225
An umbrella review of randomized control trials on the effects of physical exercise on cognition
Ciria, L. F., Román-Caballero, R., Vadillo, M. A., Holgado, D., Luque-Casado, A., Perakakis, P., & Sanabria, D. (2023) · Nature Human Behaviour · doi:10.1038/s41562-023-01554-4 · Cited by 157
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Self-citationWatts, E. L., Matthews, C. E., Freeman, J. R., Gorzelitz, J., Hong, H. G., Liao, L. M., McClain, K. M., Saint‐Maurice, P. F., Shiroma, E. J., & Moore, S. C. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.28510 · Cited by 119
Metadata
- 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 › Public Health, Environmental and Occupational Health › 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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