The effectiveness of multicomponent exercise in older adults with cognitive frailty: a systematic review and meta-analysis

Cognitive frailty, intimately tied to adverse outcomes such as falls, early mortality, and hospitalization, represents a dynamic, reversible process. Multicomponent exercise has emerged as one of the most potent means of mitigating cognitive frailty.

This research seeks to quantitively amalgamate the effects of multicomponent exercise on various domains: cognitive function, frailty status, and other health-related outcomes in cognitively frail older adults.

Our methodology entailed a comprehensive review of literature in databases including PubMed, EMbase, CINAHL, Cochrane Library, Web of Science, Wanfang, Sinomed, VIP, and CNKI from the inception of these databases to December 10, 2023. For our statistical analysis, we utilized RevMan 5.3, Stata 17.0 and R 4.3.2 software. Adherence was maintained to the PRISMA checklist, with the study being registered with PROSPERO (CRD42024499808).

Our review encapsulated a total of 2,222 participants and 11 trials. The findings intimate that multicomponent exercise enhances cognitive function [MD = 2.52, p = 0.03]), grip strength[SMD = 0.39, p = 0.008] and lower limb muscle strength[MD = 4.30, p < 0.001], while alleviating frailty[MD = -2.21, p < 0.001] and depression [MD = -1.20, p = 0.001]. However, cogent evidence is still lacking to endorse the positive effects of multicomponent exercises on both ADL(p = 0.19) and quality of life(p = 0.16). Subgroup analyses revealed beneficial effects on cognitive frailty for multicomponent exercise whose type of exercise consisted of aerobic, the duration of which exceeded 120 min per week, and whose form of exercise was group exercise.

Multicomponent exercises offer significant improvements in cognitive function, muscle strength, and have the added benefit of reducing frailty and depression in older adults. However, these exercises do not appear to influence activities of daily living and quality of life positively.