The state of the art exercise recommendations for older adults with cognitive impairments: A meta‐analysis of the meta‐analysis
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AbstractBackgroundThere is accumulative evidence supporting the benefits of regular physical activity in improving cognition in older adults with cognitive impairments (OAwCIs). In the past decades, multiple meta‐analyses (MA) have been published, adding to the body of literature. However, there is limited information on the overall quality and synthesized results of these studies. Thus, initiating an umbrella review, our review synthesis team appraised the evidence generated from the meta‐analysis reviews that included randomized exercise trials for OAwCIs.MethodUpon completing the Prospero registration (ID:109720), we followed the PRISMA guidelines for reviews and performed a literature search up to January 1, 2022 to identify all published meta‐analyses which used randomized controlled trial (RCT) design. Once all potential studies were identified, three reviewers screened and reviewed studies to identify included studies, three reviewers collected and validated the data, and two reviewers assess risk of bias using the AMSTAR 2. After applying the study’s a priori inclusion and exclusion criteria, we quantitatively analyzed the effects of exercise on cognitive performance in OAwCIs.ResultOver 2000 studies were screened for inclusion, 21 MA studies met our inclusion criteria. Based on the AMSTAR 2, three studies were high quality, nine studies were moderate quality, and nine studies were low quality. The included MA evaluated 280 RCTs, which included 22,315 participants over the age of 65 years old diagnosed with mild cognitive impairment (MCI), dementia, or Alzheimer’s disease (AD). Combined exercise training paradigms averaged 188.48±40.72 minutes per week and lasted for 18.49±4.53 weeks. Exercise training significantly improved global cognitive function, with an effect size of 0.55 (95% CI = 0.36‐0.73)ConclusionSustained and prolonged exercise training (cardio endurance type) might provide an attractive and effective intervention for individuals with MCI and AD. This comprehensive umbrella review of meta‐analyses offers valuable and strong evidence‐based exercise recommendations for OAwCIs.
