Cognitive changes are expected in ageing populations, yet effective strategies to prevent or slow cognitive decline remain an important public health priority. Lifestyle interventions have therefore emerged as promising approaches to maintain cognitive health across the lifespan. Among these lifestyle interventions, exercise has received considerable attention for its potential to promote wellbeing and preserve cognitive function in older adults. Evidence also suggests that combining exercise with other lifestyle interventions, known as multidomain interventions, may offer additional benefits by targeting multiple modifiable risk factors for dementia. However, findings from multidomain intervention trials have been inconsistent. While some studies have reported improvements in global cognitive function, executive function and processing speed, others have found limited or inconclusive effects. Moreover, multidomain interventions may require greater resources, specialist expertise and participants commitment, particularly making them more challenging for older adults to adopt. This raises an important question: can exercise alone provide cognitive benefits comparable to those of multidomain interventions? To address this question, a team of researchers led by Dr Lui-Ambrose conducted a systematic review and meta-analysis, published in the British Journal of Sports Medicine, to compare the effects of exercise as a single intervention (exercise-only) with those of exercise combined with other lifestyle interventions (exercise-plus) on executive function, memory and processing speed in older adults living without dementia.
The researchers searched four databases (MEDLINE, Embase, PsycINFO and CINAHL), and included randomised controlled trials investigating the effects of exercise-only or exercise-plus interventions on cognitive function in adults aged 60 years and older without dementia. The researchers examined the effects of the interventions using two approaches: pairwise meta-analysis, which compared two interventions at a time, and network meta-analysis, which allowed comparisons across multiple interventions. The pairwise analysis included 178 exercise-only and 67 exercise-plus comparisons, while the network analysis included 76 exercise-only and 36 exercise-plus studies. Three key comparisons were examined: exercise-only versus control, exercise-plus versus control, and exercise-plus versus exercise-only.
The findings revealed that exercise-only interventions significantly improved all three cognitive domains (executive function, memory and processing speed), compared with control. In contrast, exercise-plus interventions demonstrated a significant benefit over control only for memory. When the two intervention approaches were compared, exercise-plus was associated with greater improvements in executive function and processing speed than exercise-only, but not significantly advantage was observed for memory. These findings suggest that exercise alone can improve multiple aspects of cognitive function in older adults, while combining exercise with other lifestyle interventions may offer additional benefits for specific cognitive domains. Nevertheless, further research is needed to clarify the added value of multidomain interventions and determine which approaches provide the greatest cognitive benefits for older adults.
https://bjsm.bmj.com/content/early/2026/09/21/bjsports-2026-111684
