A Systematic Review and Meta-Analysis of Combined Cognitive and Physical Interventions on Cognition Function in Frail Older Adults

Objectives To assess the effectiveness and implementation of a combined physical and cognitive intervention in improving global cognitive function, frailty, gait speed, and depression in frail older adults. Methods A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in PROSPERO (CRD420251133290). The study conducted a literature search in 9 electronic databases of included studies from inception to July 25, 2025. Only randomized controlled trials that incorporated cognitive and physical components targeted to frail older adults were eligible. Two researchers independently conducted document retrieval, study selection, data extraction, and methodological quality evaluation. Results Eleven randomized controlled trials with a total of 989 participants were included, and meta-analyses showed that combined physical and cognitive intervention for frail older adults significantly improved global cognitive function (standardized mean difference [SMD], 1.05; 95% CI, 0.54-1.56; P < .001), reduce the level of frailty (SMD, −1.03; 95% CI, −1.54 to −0.52; P < .001), and improve gait speed (SMD, 1.12; 95% CI, 0.47-1.78; P = .0008). Combined intervention did not significantly improve depressive symptoms (SMD, −0.36; 95% CI, −1.49 to 0.76; P = .53). Conclusions and Implications Combined interventions for frail older adults can be effective in improving global cognitive function, delaying frailty progression, and more rigorous study designs and long-term follow-up are needed in the future to assess the effectiveness of combined interventions and to provide guidance on the optimal intervention strategies to improve cognitive function in frail older adults.