Abstract

BackgroundAerobic exercise remains one of the most promising approaches for enhancing cognitive function in late adulthood, yet its potential positive effects on episodic memory remain poorly understood and a matter of intense debate. Prior meta-analyses have reported minimal improvements in episodic memory following aerobic exercise but have been limited by restrictive inclusion criteria and infrequent examination of exercise parameters.MethodsWe conducted a meta-analysis of randomized controlled trials to determine if aerobic exercise influences episodic memory in late adulthood (M = 70.82 years) and examine possible moderators. Thirty-six studies met inclusion criteria, representing data from 2750 participants.ResultsHere we show that aerobic exercise interventions are effective at improving episodic memory (Hedges’g = 0.28; p = 0.002). Subgroup analyses revealed a moderating effect of age (p = 0.027), with a significant effect for studies with a mean age between 55–68 but not 69–85. Mixed-effects analyses demonstrated a positive effect on episodic memory among studies with a high percentage of females (65–100%), participants with normal cognition, studies reporting intensity, studies with a no-contact or nonaerobic physical activity control group, and studies prescribing >3900 total minutes of activity (range 540–8190 min).ConclusionsAerobic exercise positively influences episodic memory among adults ≥55 years without dementia, with larger effects observed among various sample and intervention characteristics—the clearest moderator being age. These results could have far-reaching clinical and public health relevance, highlighting aerobic exercise as an accessible, non-pharmaceutical intervention to improve episodic memory in late adulthood.

Highlights

  • Aerobic exercise remains one of the most promising approaches for enhancing cognitive function in late adulthood, yet its potential positive effects on episodic memory remain poorly understood and a matter of intense debate

  • In accordance with Aim 1, our meta-analysis of adults ≥55 years without dementia demonstrates that participation in aerobic exercise (AE) improves episodic memory (EM)

  • In accordance with Aim 2, we found that AE improved EM in studies with normal cognition (NC), those with a mean age of 55–68, and those above the median in female participants

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Summary

Methods

We conducted this meta-analysis in accordance with established guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)[38]. All studies of participants with NC, SCD, and MCI were included, regardless of the diagnostic criteria used. Studies that included strength training, exergaming, or cognitive training as part of the AE group were excluded because of their potential confounding impact on cognition through nonaerobic mechanisms. One study that produced three publications described their methods as including some sessions in the anaerobic zone[39,40]. These publications were included here because the majority of the duration of the intervention was conducted in the aerobic zone; (3) Control group type could include no contact, wait-list, stretching, toning, balance, light resistance, education, or social interaction

Results
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