Digital Physical Exercise Interventions for Cognitive Functions in Older Adults: Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials
Abstract
Background: Cognitive decline in older adults imposes a major global burden, with physical inactivity a leading modifiable risk factor for dementia. Digital physical exercise interventions offer scalable alternatives to traditional programs, but comparative effectiveness across cognitive domains remains unclear.
Objective: The aim of the study is to compare and rank 4 digital physical exercise interventions-immersive virtual reality exercise (IVR_E), nonimmersive exergame (NI_ExG), remote exercise (RE), and virtual reality exercise combined with cognitive training (VR_EC)-against routine intervention (RI) or nonintervention (NI) on global cognition, executive function, and memory function in older adults aged ≥60 years.
Methods: Eligible studies were English-language randomized controlled trials evaluating digital physical exercise on any untrained cognitive outcome in older adults. In total, 6 databases (PubMed, Embase, Web of Science, CENTRAL, PsycINFO, and CINAHL) and 2 trial registries were searched from January 2010 to April 2026; reference lists were screened. Screening, data extraction, and risk-of-bias assessment were conducted independently in duplicate using the Cochrane tool. Bayesian network meta-analyses were performed in R, reporting standardized mean differences (SMDs) with 95% CIs and prediction intervals (PIs); surface under the cumulative ranking curve (SUCRA) ranked interventions, and CINeMA (Confidence in Network Meta-Analysis) assessed certainty of…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,673 participants or records.
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