Effects of exercise on older adults with mild cognitive impairment: A systematic review and network meta-analysis

Background: Mild cognitive impairment (MCI) represents a transitional stage between normal aging and Alzheimer's disease (AD), with a significantly elevated risk of progressing to AD. In recent years, accumulating evidence has indicated that exercise interventions may mitigate cognitive decline in individuals with MCI and reduce the risk of conversion to AD, potentially through mechanisms such as enhancing cerebral blood flow and promoting neuroplasticity. Objective: To explore which type of exercise is most effective in improving global cognition in older adults with MCI and to investigate whether exercise can enhance their balance abilities. Methods: Randomized controlled trials were retrieved from four databases. Stata software was used for Network Meta-Analysis and traditional meta-analysis. Results: A total of 33 studies were included, of which 28 were used to determine the best exercise modality. The results indicated that multicomponent exercise (SUCRA = 76.5%) and moderate-intensity aerobic exercise (SUCRA = 73.6%) are two effective modalities. The results of the traditional meta-analysis showed that exercise combined with cognitive training, moderate-intensity aerobic exercise, resistance exercise, and land-based kayaking training can improve balance ability. Conclusions: Multicomponent exercise may be the optimal exercise modality for enhancing global cognition in older adults with MCI, and various exercise modalities can improve balance abilities. However, more studies with larger sample sizes and higher quality are needed to provide further evidence.