Clinician Article
Effects of physical exercise on executive function in cognitively healthy older adults: A systematic review and meta-analysis of randomized controlled trials: Physical exercise for executive function.
PMID: 33248291
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Public HealthRelevance - 6/7
Newsworthiness - 6/7 -
Family Medicine (FM)/General Practice (GP)Relevance - 6/7
Newsworthiness - 4/7 -
General Internal Medicine-Primary Care(US)Relevance - 6/7
Newsworthiness - 4/7 -
Physical Medicine and RehabilitationRelevance - 5/7
Newsworthiness - 5/7 -
GeriatricsRelevance - 5/7
Newsworthiness - 3/7
Abstract
OBJECTIVE: To assess the effect of physical exercise interventions on executive function in cognitively healthy adults aged 60 years and older.
METHODS: Four electronic databases, the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science and Embase, were comprehensively searched from their inception to November 25, 2019. Randomized controlled trials (RCTs) examining the effect of physical exercise on executive function in cognitively healthy older adults were included.
RESULTS: Twenty-five eligible trials with fair methodological quality were identified. Compared to a no-exercise intervention, physical exercise had positive effect on working memory (Hedge's g=0.127, p<0.01, I2= 0%), cognitive flexibility (Hedge's g=0.511; p=0.007, I2=89.08%), and inhibitory control (Hedge's g=0.136; p=0.001, I2=0%) in cognitively healthy older adults. The moderator analysis indicated that more than 13 weeks of aerobic exercise significantly improved working memory and cognitive flexibility, and intervention lasting more than 26 weeks significantly improved inhibition; mind-body exercise significantly improved working memory. No significant effect on planning or semantic verbal fluency (SVF) was found.
CONCLUSION: Regular physical exercise training, especially aerobic exercise and mind-body exercise, had positive benefit for improving working memory, cognitive flexibility and inhibitory control of executive function in cognively healthy older adults. Further well-designed RCTs should focus on the impact of specific exercise forms with a standardized exercise scheme on executive function in cognitively healthy older adults.
Clinical Comments
Family Medicine (FM)/General Practice (GP)
This is reassuring. It's hard to avoid several kinds of bias in these sort of studies, some of which were mentioned in the paper.
Geriatrics
This systematic review examined the effects of physical exercise and different exercise types on executive function in cognitively healthy older adults enrolled in eligible RCTs/randomized cross-over trials. All included studies had some bias concerns and overall there was also evidence of publication bias. Regular physical exercise training, especially aerobic exercise and mind-body exercise, had statistically positive benefits on working memory, cognitive flexibility and inhibitory control of executive function but the clinical relevance of this finding was not considered. While a helpful summary of research addressing this particular topic, I do not see it being directly relevant to clinical practice. There are more established reasons to encourage older persons to be more physically active. This would be at best supportive evidence for older adults to act on this recommendation.
Geriatrics
In this important study, the authors found a beneficial effect of exercise on cognitive function. This intervention has broader clinical implication beyond cognitive function.
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