Efficacy of traditional Chinese exercises on cognitive function in older adults: a systematic review and meta-analysis of randomised controlled trials

Abstract

Background: Cognitive impairment is a significant health concern among older adults, highlighting the need for non-pharmacological interventions, such as mind-body exercises. However, a comprehensive synthesis of the effects of various traditional Chinese exercises (TCEs) on cognitive function in older adults is lacking.

Methods: A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted. Six databases were searched from inception to 2 May 2024 for studies examining the effects of TCEs on cognitive outcomes in adults aged 60 years and older. Studies were included if they were RCTs involving TCEs and reported outcome measures for global cognition, or individual cognitive domains.

Results: Twenty-eight RCTs with a total of 2297 participants were included. Meta-analysis revealed that TCEs led to significant improvements in global cognition: Montreal Cognitive Assessment [mean differences (MD) = 1.67; 95% confidence interval (CI): (1.20, 2.14)], Mini-Mental State Examination [MD = 0.76; 95% CI: (0.04, 1.48)]; executive function: Trail Making Test (B-A) [MD = -7.96; 95% CI: (-15.34, -0.59)], Category Fluency for Animals [MD = 2.96, 95% CI (2.08, 3.85)]; working memory: Digit Span-Backwards [MD = 0.48; 95% CI: (0.07, 0.90)]; processing speed: Digit Symbol Coding [MD = 4.16; 95% CI: (1.82, 6.50)]; memory function: Memory Quotient [MD = 13.13; 95% CI: (4.06, 22.20)], Auditory Verbal Learning Test: immediate recall [MD = 1.13; 95% CI: (0.07, 2.20)], short-term delayed recognition [MD = 0.80; 95% CI: (0.28, 1.32)] and long-term delayed recognition [MD = 1.38; 95% CI: (0.68, 2.09)].

Conclusions: TCEs are effective in improving cognitive function in older adults, particularly in domains such as global cognition, executive function, working memory, processing speed and memory function. However, given the methodological limitations and heterogeneity of the included studies, these findings require confirmation in further large-scale, high-quality RCTs.

Keywords: cognitive function; meta-analysis; older adults; randomised controlled trial; systematic review; traditional Chinese exercises.