Effects of Traditional and Technology-Based Exercise Interventions on Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis

Abstract

Background: As population aging accelerates, pharmacological treatments provide limited benefits for cognitive decline. Exercise and technology-assisted exercise have thus emerged as important non-pharmacological approaches for supporting cognitive health in older adults. However, comparative evidence on the relative effectiveness of different intervention modalities across cognitive outcomes remains limited. Objective: This study used a network meta-analysis to systematically compare and rank the effects of traditional and non-traditional exercise interventions on cognitive function in older adults. Methods: This systematic review and network meta-analysis was registered on PROSPERO (CRD420261278685). PubMed, Embase, the Cochrane Library, Web of Science, and Scopus were searched from inception to May 2026. Randomized controlled trials enrolling participants aged 60 years or older were included. Interventions comprised aerobic, resistance, mind–body, finger, and multicomponent exercise, as well as virtual reality-based interventions, artificial intelligence-assisted exercise, and wearable exoskeleton training. Primary outcomes included global cognition, executive function, memory, attention, and activities of daily living. A random effects network meta-analysis was applied to estimate standardized mean differences with 95 percent confidence intervals, and intervention rankings were derived using SUCRA values. Results: A total of 70 randomized controlled trials involving 5573 older adults were included. All active interventions demonstrated overall cognitive benefits compared with usual care or non-active control conditions. Mind–body exercise showed the highest probability of improving global cognitive performance. Virtual reality-based interventions were particularly effective for executive function, memory, and activities of daily living, while artificial intelligence-assisted exercise showed favorable rankings for attention outcomes. Mind–body exercise showed favorable effects on global cognition, whereas several technology-assisted interventions ranked highly for selected cognitive and functional outcomes. Conclusions: Both traditional and non non-traditional exercise interventions improve cognitive function in older adults, although their effects differ across cognitive domains. Technology-assisted approaches appear more effective for enhancing specific cognitive functions, while traditional interventions such as mind–body exercise are more advantageous for preserving overall cognitive performance. These findings highlight the potential value of stage specific and combined intervention strategies for promoting cognitive health in aging populations.