Effects of Exercise Intervention on Functional Mobility among Older Adults with Cognitive Impairment: A Quantitative Evidence

Objectives: This meta-analysis aimed to assess the effect of exercise interventions on functional mobility among older adults with cognitive impairments such as dementia or mild cognitive impairment, followed by further investigation on the possible moderators of exercise-induced effects on this outcome. Design: A meta-analysis of controlled trials on exercise interventions reporting functional mobility outcomes was conducted. PubMed, Embase, EBSCO, SPORTDiscus, and Web of Science were searched for relevant studies published in English-language journals through July 2024. Setting and Participants: Clinical and community settings across 15 countries, including a total of 1104 older adults with cognitive impairment, were involved in the study. Methods: We computed pooled effect sizes based on standardized mean difference (SMD) using the random-effects models. The subgroup analyses and meta-regression were conducted for multiple moderating variables (eg, exercise, sample, and study characteristics). The study quality was evaluated using the Physiotherapy Evidence Database Scale. Results: This meta-analysis finally included 22 studies. Results revealed that exercise interventions effectively improved functional mobility as compared with that of the control group (SMD,-0.42; 95% CI,-0.61 to-0.24; P < .001). Exercise intervention characteristics (ie, weekly training frequency and session duration) and sample characteristic (ie, percentage of women) moderated the exercise-induced effects on this interesting outcome. Subgroup analyses showed intervention with low frequency (1e2 times/wk) (SMD,-0.71; 95% CI,-1.01 to-0.42; P <.001) had a larger improvement in mobility, followed by medium frequency (SMD,-0.33; 95% CI,-0.56 to-0.10; P < .01). In addition, interventions with a session duration of > 60 minutes (SMD,-0.60; 95% CI,-0.84 to-0.36; P < .001) and 45 to 60 minutes (SMD,-0.60; 95% CI,-0.91 to-0.29; P < .001) had a significant improvement in mobility. Moreover, exercise training had a significant improvement in mobility for studies with a high percentage of women (SMD,-0.49; 95% CI,-0.67 to-0.31; P < .001). Conclusions and Implications: Exercise intervention is a promising way to improve functional mobility among older adults with cognitive impairment. Further evidence suggests that larger effects were observed in exercise intervention features of more than 45-minute session duration 1 to 3 times a week for at least 6 weeks regardless of exercise type. In addition, women benefit more from exercise interventions than men. Our study highlights that health care providers should prioritize integrating structured exercise programs into routine care for this population. (c) 2025 Post-Acute and Long-Term Care Medical Association.