The effects of cognitive-motor training interventions on executive functions in older people: a systematic review and meta-analysis

Wollesen, Bettina; Wildbredt, Alicia; van Schooten, Kimberley S.; Lim, Mei Ling; Delbaere, Kim · 2020 · OpenAlex-citations

DOI: 10.1186/s11556-020-00240-y

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Summary

This systematic review and meta-analysis investigates the effectiveness of cognitive-motor training interventions, including exergaming, on executive functions (EF) in healthy older adults. The study addresses the decline in physical and cognitive performance associated with aging, which compromises independence and increases fall risk. Specifically, it examines whether dual-task interventions—combining motor tasks like walking or standing with cognitive demands—can improve global cognition and specific EF domains, including inhibitory control, working memory, and cognitive flexibility. The authors conducted a comprehensive search of MEDLINE, EMBASE, and PsychINFO databases for randomized controlled trials, controlled clinical trials, and parallel group trials published up to 2019. Inclusion criteria required community-dwelling participants aged 60 or older without significant medical conditions or cognitive deficits. Interventions had to involve simultaneous cognitive and motor tasks, delivered via traditional methods or modern technology. Of 1,557 retrieved studies, 25 met the inclusion criteria. Quality was assessed using the PEDro scale, with most studies rated as high quality. Meta-analyses were performed using a random-effects model to estimate mean differences in cognitive outcomes, with subgroup analyses for active versus inactive controls. The results demonstrated that cognitive-motor interventions had a significant positive effect on global cognitive function (mean difference 0.6, 95% CI 0.29–0.90) and inhibitory control (mean difference 0.61, 95% CI 0.28–0.94). However, these effects exhibited high heterogeneity (I² range 60–95%) and did not remain significant after sensitivity analysis. Improvements were also observed in processing speed and dual-task costs, though these outcomes could not be pooled in a meta-analysis. The review distinguished between general dual-task training, which uses varied tasks, and specific dual-task training, which mirrors assessment tasks. Technology-based exergame interventions were found to improve processing speed, attentional control, and inhibitory control. The study concludes that cognitive-motor and technology-based interventions positively impact certain cognitive functions in older adults, particularly global cognition and inhibitory control. The authors suggest that interventions with a specific exercise load, characterized by progression in difficulty and task specificity, are more effective for inducing task-related cognitive adaptations. These findings support the use of dual-task training as a viable strategy to mitigate age-related cognitive decline and enhance daily-life functioning in the elderly.

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• cognitive impairment