Effects of visual art therapy on cognitive function in older adults: a systematic review and meta-analysis

Abstract

Objective To systematically review the evidence on the effects of visual art therapy on global cognitive function in older adults, and to examine its impact on verbal fluency, naming ability, and activities of daily living. Methods A systematic search was conducted in PubMed, Web of Science, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Database, Wanfang Database, and VIP Database for randomized controlled trials (RCTs) published from database inception to July 2026. Meta-analysis was performed using RevMan 5.4 and Stata 15.0. The primary outcome was global cognitive function, and secondary outcomes included the Verbal Fluency Test (VFT), the Boston Naming Test (BNT), and activities of daily living. Fixed-effects or random-effects models were used according to heterogeneity, and subgroup analyses were conducted. Results A total of 10 randomized controlled trials involving 628 older participants were included, of whom 318 were allocated to visual art therapy and 310 to control conditions. Meta-analysis showed that visual art therapy significantly improved global cognitive function in older adults (SMD = 0.39, 95% CI: 0.23–0.54, P < 0.00001). For secondary outcomes, compared with control groups, statistically significant improvements were observed in verbal fluency (MD = 1.21, 95% CI: 0.12–2.29, P = 0.03), naming ability (MD = 1.74, 95% CI: 0.20–3.28, P = 0.03), and activities of daily living (SMD = −0.36, 95% CI: −0.62 to −0.10, P = 0.006) in the visual art therapy group. However, the evidence is based on only two or three studies and was rated as low or very low certainty. Subgroup analyses indicated larger effect sizes for interventions delivered 13–24 times, with 30–40 minutes per session, and among older adults with mild cognitive impairment, given the limited number of studies per subgroup, these findings are exploratory and should be interpreted with caution. Conclusion Visual art therapy can significantly enhance global cognitive function in older adults and confers additional benefits on language functions and activities of daily living. As a safe, non-invasive, non-pharmacological intervention, visual art therapy may serve as an effective adjunctive approach for managing cognitive decline and daily functioning in the older population. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261337553, identifier CRD420261337553.