Enhancing Cognitive Function and Well-being in Older Adults With Cognitive and Physical Decline: A Meta-analysis of Randomized Controlled Trials Examining Physical Activity Interventions

Cognitive frailty, defined by the coexistence of physical frailty and mild cognitive impairment, can be reversed through targeted interventions. This meta-analysis evaluated the efficacy of physical activity interventions on cognitive function and well-being in older adults with frailty. The databases (ProQuest, PubMed, CINAHL Ultimate, and Scopus) and Google Scholar were searched to identify relevant articles published from 1990 to March 2025. Our analyses included randomized controlled trials evaluating the effects of physical activity interventions on cognitive function and well-being in older adults with cognitive or physical frailty. Forty-two randomized controlled trials involving 4740 older adults were included. The meta-analysis categorized interventions into multicomponent exercise, resistance training, aerobic exercise, and mindfulness-based activities. Physical activity interventions produced small-to-moderate improvements in global cognition (g = 0.442), attention (g = 0.267), and executive function (g = 0.279). No significant effect was found for memory (g = -0.020). Moderate effects were observed for physical health-related quality of life (g = 0.600), and moderate-to-large effects were found for psychological well-being (g = 0.710). Multicomponent and resistance-based programs are effective strategies to promote cognitive function, psychological well-being, and physical health-related quality of life in older adults with frailty. Tailored physical activity programs should be considered in geriatric care to optimize healthy aging.