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Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis
Open accessAbstract
Background: Physical exercise is seen as a promising intervention to prevent or delay cognitive decline in individuals aged 50 years and older, yet the evidence from reviews is not conclusive. Objectives: To determine if physical exercise is effective in improving cognitive function in this population. Design: Systematic review with multilevel meta-analysis. Data sources: Electronic databases Medline (PubMed), EMBASE (Scopus), PsychINFO and CENTRAL (Cochrane) from inception to November 2016. Eligibility criteria: Randomised controlled trials of physical exercise interventions in community-dwelling adults older than 50 years, with an outcome measure of cognitive function. Results: The search returned 12 820 records, of which 39 studies were included in the systematic review. Analysis of 333 dependent effect sizes from 36 studies showed that physical exercise improved cognitive function (0.29; 95% CI 0.17 to 0.41; p<0.01). Interventions of aerobic exercise, resistance training, multicomponent training and tai chi, all had significant point estimates. When exercise prescription was examined, a duration of 45–60 min per session and at least moderate intensity, were associated with benefits to cognition. The results of the meta-analysis were consistent and independent of the cognitive domain tested or the cognitive status of the participants. Conclusions: Physical exercise improved cognitive function in the over 50s, regardless of the cognitive status of participants. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that patients obtain both aerobic and resistance exercise of at least moderate intensity on as many days of the week as feasible, in line with current exercise guidelines.
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“The first included 39 RCTs with an unclear total number of participants examining moderate or vigorous exercise of any frequency lasting 45–60 min per session in cognitively normal adults aged older than 50 years. This analysis reported global cognitive improvements (standard mean difference [SMD]=0·3, 95% CI 0·2–0·4) for moderate or vigorous resistance (13 studies) or aerobic exercise (18 studies”
From Dementia prevention, intervention, and care: 2020 report of the Lancet Commission (2020) · cites this paper as [93]
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In the citing paper
“There is encouraging evidence for resistance training in people with elevated mental health symptoms [108-114], but this requires further testing in those with mental disorders.”
From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [111]
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“physical exercise has emerged as a promising non-pharmacological intervention for promoting brain health (Northey et al., 2018).”
From Optimal exercise interventions for enhancing cognitive function in older adults: a network meta-analysis (2025) · cites this paper as Northey et al., 2018
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“Future interventions should also examine the role of resistance training for improving cognition in serious mental illness, since there is a clear association between increased muscular strength and cognition in people with major depression, bipolar disorder and schizophrenia [108, 109] and evidence from the general population indicates resistance training can improve cognition [110, 111].”
From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [111]
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“While pharmacological treatments for cognitive impairment remain limited in efficacy and carry potential adverse effects”
From Optimal exercise interventions for enhancing cognitive function in older adults: a network meta-analysis (2025) · cites this paper as Northey et al., 2018
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“The effect of exercise to prevent or ameliorate cardiotoxicity is an emerging field of research and promising results for a protective effect of exercise in animal models and some novel evidence in humans for cardiac function(55), including measures of left ventricular function(55), and vascular endothelial function, measured as flow-mediated dilation(56).”
From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [56]
In the citing paper
“In another meta-analysis of 39 RCTs examining the effects of PA on cognitive function in individuals over the age of 50, PA improved cognition with an effect size of 0.29 (16).”
From Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines (2019) · cites this paper as [16]
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“Similarly, Northey et al. (16) reported that moderate intensity PA for 45-60 minutes per session were associated with benefits to cognition in adults over the age of 50.”
From Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines (2019) · cites this paper as [16]
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“we argue that the consistency of effects and of effect sizes across populations (16, 26), durations of PA (including acute bouts), intensities, comorbid conditions (58), and ages (12) is truly remarkable”
From Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines (2019) · cites this paper as [16]
In the citing paper
“Regular physical exercise is recommended to all older adults, and indeed to those at increased risk of AD, as it may improve physical health, reduce frailty, lower the risk of depression, improve cognitive function in the short and long term (26–31).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [31]
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Metadata
- Authors
- Northey, J. M., Cherbuin, N., Pumpa, K. L., Smee, D. J., & Rattray, B.
- Affiliations
- University of Canberra (AU)
- Australian National University (AU)
- Corresponding author
- Northey, Joseph Michael
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2017-04-24
- Volume
- 52
- Issue
- 3
- Pages
- 154-160
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2608193295
- Cited by
- 1,380
- References
- 74
- Citations by year
- 2026: 168 · 2025: 184 · 2024: 185 · 2023: 162 · 2022: 180 · 2021: 183 · 2020: 155 · 2019: 98 · 2018: 52 · 2017: 12
- FWCI
- 13.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- University of Canberra Research Portal (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- 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
- physical activity, cognitive function, older adults, cognitive decline, aerobic exercise, resistance training, Tai Chi, multicomponent training, exercise prescription, exercise intensity, exercise duration, community-dwelling older adults
- MeSH terms
- Attention, Cognition, Exercise Therapy, Humans, Memory, Short-Term, Middle Aged, Exercise, Randomized Controlled Trials as Topic, Tai Ji, Resistance Training, Executive Function
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