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Cited by 59Transcranial Magnetic Stimulation StudiesDementia and Cognitive Impairment ResearchPhysical Activity and Health

The effects of aerobic exercise and transcranial direct current stimulation on cognitive function in older adults with and without cognitive impairment: A systematic review and meta-analysis.

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Talar, K., Vetrovsky, T., van Haren, M., Négyesi, J., Granacher, U., Váczi, M., Martín-Arévalo, E., Del Olmo, M.F. +2 more·2022·Ageing Research Reviews
DOI 10.1016/j.arr.2022.101738
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Abstract

BACKGROUND: Aerobic exercise (AE) may slow age-related cognitive decline. However, such cognition-sparing effects are not uniform across cognitive domains and studies. Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation and is also emerging as a potential alternative to pharmaceutical therapies. Like AE, the effectiveness of tDCS is also inconsistent for reducing cognitive impairment in ageing. The unexplored possibility exists that pairing AE and tDCS could produce synergistic effects and reciprocally augment cognition-improving effects in older individuals with and without cognitive impairments. Previous research found such synergistic effects on cognition when cognitive training is paired with tDCS in older individuals with and without mild cognitive impairment (MCI) or dementia. AIM: The purpose of this systematic review with meta-analysis was to explore if pairing AE with tDCS could augment singular effects of AE and tDCS on global cognition (GC), working memory (WM) and executive function (EF) in older individuals with or without MCI and dementia. METHODS: Using a PRISMA-based systematic review, we compiled studies that examined the effects of AE alone, tDCS alone, and AE and tDCS combined on cognitive function in older individuals with and without mild cognitive impairment (MCI) or dementia. Using a PICOS approach, we systematically searched PubMed, Scopus and Web of Science searches up to December 2021, we focused on 'MoCA', 'MMSE', 'Mini-Cog' (measures) and 'cognition', 'cognitive function', 'cognitive', 'cognitive performance', 'executive function', 'executive process', 'attention', 'memory', 'memory performance' (outcome terms). We included only randomized controlled trials (RTC) in humans if available in English full text over the past 20 years, with participants' age over 60. We assessed the methodological quality of the included studies (RTC) by the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Overall, 68 studies were included in the meta-analyses. AE (ES = 0.56 [95% CI: 0.28-0.83], p = 0.01) and tDCS (ES = 0.69 [95% CI: 0.12-1.26], p = 0.02) improved GC in all three groups of older adults combined (healthy, MCI, demented). In healthy population, AE improved GC (ES = 0.46 [95% CI: 0.22-0.69], p = 0.01) and EF (ES = 0.27 [95% CI: 0.05-0.49], p = 0.02). AE improved GC in older adults with MCI (ES = 0.76 [95% CI: 0.21-1.32], p = 0.01). tDCS improved GC (ES = 0.69 [90% CI: 0.12-1.26], p = 0.02), all three cognitive function (GC, WM and EF) combined in older adults with dementia (ES = 1.12 [95% CI: 0.04-2.19], p = 0.04) and improved cognitive function in older adults overall (ES = 0.69 [95% CI: 0.20-1,18], p = 0.01). CONCLUSION: Our systematic review with meta-analysis provided evidence that beyond the cardiovascular and fitness benefits of AE, pairing AE with tDCS may have the potential to slow symptom progression of cognitive decline in MCI and dementia. Future studies will examine the hypothesis of this present review that a potentiating effect would incrementally improve cognition with increasing severity of cognitive impairment.

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  • Heterogeneity was assessed using the I2 statistic, with I2 above 50% indicating substantial heterogeneity and a random-effects model applied; otherwise a fixed-effects model was used.

    “Heterogeneity among studies was assessed using the I2 statistic, where an I2 value above 50% indicated substantial heterogeneity, and a random-effects model was applied. Otherwise, a fixed-effects model was used (Talar et al., 2022).”

    From Optimal exercise interventions for enhancing cognitive function in older adults: a network meta-analysis (2025) · cites this paper as Talar et al., 2022

    Section 2.6 (Statistical Analysis) confirms that the paper assessed heterogeneity using I², but it says I² >50% indicates moderate heterogeneity. More importantly, it states that a random-effects method was used in all analyses, contrary to the claimed switch to a fixed-effects model otherwise. (LLM, conf=0.90)

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Authors
Talar, K., Vetrovsky, T., van Haren, M., Négyesi, J., Granacher, U., Váczi, M., Martín-Arévalo, E., Del Olmo, M. F., Kałamacka, E., & Hortobágyi, T.
Affiliations
  • University of Physical Culture in Kraków (PL)
  • Tohoku University (JP)
  • University of Freiburg (DE)
  • University of Pecs (HU)
  • University Medical Center Groningen (NL)
Corresponding author
Talar, K.
ORCID
Venue
Ageing Research Reviews
Publisher
Elsevier BV
Published
2022-11
Volume
81
Pages
101738
ISSN
1568-1637 (ISSN-L)
DOI
10.1016/j.arr.2022.101738
OpenAlex
W4296887696
Cited by
59
References
16
Citations by year
2026: 19 · 2025: 15 · 2024: 16 · 2023: 9
FWCI
1.02
Type
journal article
Language
en
Open access
Licence
Locations
  • Ageing Research Reviews (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Institutional Repository of the University of Granada (University of Granada) (submittedVersion, cc-by)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
Funders
Univerzita Karlova v Praze
Topics
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
aerobic exercise, transcranial direct current stimulation, cognitive function, older adults, mild cognitive impairment, dementia, global cognition, working memory, executive function, age-related cognitive decline, non-invasive brain stimulation, cognitive training, synergistic effect, cognitive rehabilitation, neuroplasticity, neurogenesis, neuroinflammation, neurodegeneration, neuroprotection
MeSH terms
Aged, Dementia, Pharmaceutical Preparations, Humans, Exercise, Cognitive Dysfunction, Transcranial Direct Current Stimulation

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