Exercise and Cognitive Aging: A Meta-Analysis of Macrovascular Cerebral Blood Flow and Cognitive Function in Older Adults

Area of Science:

• Gerontology
• Neuroscience
• Exercise Physiology

Background:

• Cognitive decline is a significant public health issue in aging populations.
• Reductions in cerebral blood flow (CBF) are closely linked to cognitive decline.
• The precise impact of exercise on cognitive function and cerebrovascular health requires further clarification.

Purpose of the Study:

• To systematically review and analyze the effects of exercise on cognitive function and cerebral blood flow (CBF) in older adults.
• To investigate the relationship between CBF and cognitive outcomes following exercise interventions.
• To provide evidence-based support for exercise as a non-pharmacological intervention for brain health.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) and controlled trials published up to January 2024.
• Inclusion of 57 studies on cognitive function and 12 on CBF from major scientific databases.
• Calculation of standardized mean differences (SMDs) and weighted mean differences (WMDs) using fixed- or random-effects models, with regression analysis for CBF-cognition association.

Main Results:

• Exercise interventions significantly improved cognitive function (SMD = 0.52), particularly in inhibitory control, switching, memory, and verbal fluency.
• Exercise increased middle cerebral artery velocity (MCAv) (WMD = 1.88) and enhanced cardiovascular efficiency by reducing resting heart rate and pulse index (PI).
• Higher CBF was positively correlated with cognitive performance, especially in memory and verbal fluency.

Conclusions:

• Exercise enhances cognitive function in older adults through improved macrovascular cerebral blood flow and cardiovascular efficiency.
• Increased MCAv and reduced PI following exercise underscore its positive impact on macrovascular CBF and cognitive health.
• Structured exercise programs are recommended as a non-pharmacological strategy to promote brain health and delay cognitive decline in the elderly.