The comprehensive impact of exercise interventions on cognitive function and quality of life in alzheimer’s disease patients: a systematic review and meta-analysis

BACKGROUND: Alzheimer's Disease (AD) is a progressive neurodegenerative disorder marked by cognitive decline and reduced quality of life. Exercise interventions are considered a promising non-pharmacological strategy to enhance cognition and well-being in AD patients. However, effects across different cognitive domains and quality of life remain unclear due to variations in study designs, intervention types, and outcome measures. OBJECTIVE: This systematic review and meta-analysis evaluated the effects of exercise interventions on cognitive function, executive function, memory, and quality of life in AD patients by synthesizing evidence from randomized controlled trials (RCTs). METHODS: We conducted a comprehensive search in PubMed, Embase, and Web of Science. Forty-five studies met inclusion criteria and were included in the quantitative synthesis. Primary outcomes included global cognition, executive function, memory, and quality of life. Meta-analyses were performed using standardized mean differences (SMD) and 95% confidence intervals (CI). Risk of bias was assessed via the Cochrane tool, and heterogeneity was quantified using the I² statistic. RESULTS: Exercise interventions Significantly improved global cognition, with SMDs of 0.30 (95% CI: 0.17-0.43, p < 0.00001) for MMSE and 0.39 (95% CI: 0.08-0.70, p = 0.01) for MoCA, with low heterogeneity (I² = 36% and 0%). ADAS-Cog showed a small, non-significant effect (SMD = - 0.09, 95% CI: - 0.35 to 0.17, p = 0.49). Executive function (SMD = 0.13, p = 0.09) and memory (SMD = 0.09, p = 0.34) did not improve significantly. Quality of life improved significantly (SMD = 0.17, 95% CI: 0.03-0.31, p = 0.02; I² = 5%), measured using tools such as QOL-AD and Qualidem. CONCLUSION: Evidence suggests that structured, multimodal exercise programs-combining aerobic (≥ 150 min/week), resistance (2-3 times/week), and balance training (2-3 times/week) for at least 12 weeks with individualized intensity-may improve global cognition and quality of life in Alzheimer's disease patients.