The effects of structured aerobic exercise and mind-body exercise on cognitive function in older adults with MCI: Systematic review and meta-analysis.

Abstract

<h4>Background</h4>Global aging has increased the prevalence of dementia, with mild cognitive impairment (MCI) representing a critical window for intervention. While exercise is recognized for mitigating cognitive decline, the comparative effectiveness of mind-body versus structured aerobic exercise remains unclear.<h4>Methods</h4>Search sources included PubMed, Web of Science, and the Cochrane Library. Randomized controlled trials (RCTs) assessing mind-body exercise (tai chi, yoga, and dance) or structured aerobic exercise (walking and cycling) in patients with MCI aged over 50 years were included. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) were used as outcome measures. Random- or fixed-effects meta-analyses were conducted using RevMan 5.4.1. Heterogeneity was assessed using the I2 statistic. Subgroup analyses examined intervention parameters.<h4>Results</h4>Twenty-six randomized controlled trials (n = 2,555) were included. Mind-body exercise significantly improved MMSE (mean difference [MD] = 1.27, 95% confidence interval [CI]: 0.99-1.55, P < .01), MoCA (MD = 1.89, 95% CI: 0.78-3.00, P = .0008), and ADAS-Cog (MD = -2.09, 95% CI: -2.94 to -1.25, P < .00001) versus controls. Structured aerobic exercise showed non-significant effects on MMSE (MD = 0.37, P = .21) and MoCA (MD = -0.49, P = .26), with modest improvement on ADAS-Cog (MD = -1.41, P = .002). Optimal mind-body parameters include ≥20 weeks' duration, ≥60 minutes per session, and ≥3 times per week.<h4>Conclusions</h4>Mind-body exercise demonstrates superior cognitive benefits compared with structured aerobic exercise in older adults with MCI. It is advised to prioritize mind-body exercise interventions at least 3 times per week, for 60 minutes per session, for at least 20 weeks. Limitations include heterogeneity and geographic bias; these findings warrant confirmation through multicenter trials.