Table 4.
Effect of exercise on cognitive outcomes in mild cognitive impairment
| Certainty assessment | No. of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Intervention | Standard care | Relative (95% CI) | Absolute (95% CI) | ||
| Short-term memory (mind body intervention) | ||||||||||||
| 12 | Randomized controlled trials | Very seriousa | Not serious | Not serious | Not serious | None | 356 | 387 | – |
SMD 0.74 SD higher (0.57 higher to 0.91 higher) |
⨁⨁◯◯ Low |
Important |
| Short-term memory (Tai Chi intervention) | ||||||||||||
| 4 | Randomized controlled trials | Very seriousa | Not serious | Not serious | Seriousd | None | 114 | 112 | – |
SMD 0.77 SD higher (0.45 higher to 1.09 higher) |
⨁◯◯◯ Very low |
Important |
| Global cognition (mind body intervention) | ||||||||||||
| 9 | Randomized controlled trials | Very seriousa | Not serious | Not serious | Not serious | None | 425 | 557 | – |
SMD 0.36 SD higher (0.2 higher to 0.52 higher) |
⨁⨁◯◯ Low |
Important |
| Executive function (mind body intervention) | ||||||||||||
| 9 | Randomized controlled trials | Very seriousa | Not serious | Not serious | Not serious | None | 426 | 474 | – |
SMD 0.42 SD lower (0.63 lower to 0.21 lower) |
⨁⨁◯◯ Low |
Important |
| Global cognition (mixed physical activity intervention) | ||||||||||||
| 8 | Randomized controlled trials | Seriouse | Not serious | Not serious | Not serious | None | 347 | 316 | – |
SMD 0.3 SD higher (0.11 higher to 0.49 higher) |
⨁⨁⨁◯ Moderate |
Important |
| Global cognition (resistance training intervention) | ||||||||||||
| 4 | Randomized controlled trials | Very seriousa | Seriousf | Not serious | Seriousd | None | 77 | 69 | – |
SMD 0.8 SD higher (0.29 higher to 1.31 higher) |
⨁◯◯◯ Very low |
Important |
| Visuospatial executive function (mind body intervention) | ||||||||||||
| 4 | Randomized controlled trials | Very seriousa | Not serious | Not serious | Not serious | None | 163 | 162 | – |
SMD 0.36 SD higher (0.07 higher to 0.64 higher) |
⨁⨁◯◯ Low |
Important |
| Delayed memory (aerobic exercise intervention) | ||||||||||||
| 7 | Randomized controlled trials | Not serious | Seriousf | Not serious | Not serious | None | 638 | 675 | – |
SMD 0.26 SD higher (0.06 higher to 0.46 higher) |
⨁⨁⨁◯ Moderate |
Important |
| Attention (mind body intervention) | ||||||||||||
| 5 | Randomized controlled trials | Very seriousa | Not serious | Not serious | Not serious | None | 185 | 180 | – |
SMD 0.39 SD higher (0.07 higher to 0.72 higher) |
⨁⨁◯◯ Low |
Important |
| Processing speed (mind body intervention) | ||||||||||||
| 4 | Randomized controlled trials | Very seriousg,h | Not serious | Not serious | Seriousd | None | 184 | 184 | – |
SMD 0.1 SD higher (0.005 lower to 0.63 higher) |
⨁◯◯◯ Very low |
Important |
| Immediate recall (aerobic exercise) | ||||||||||||
| 6 | Randomized controlled trials | Not serious | Seriousf | Not serious | Not serious | None | 338 | 339 | – |
SMD 0.26 SD higher (0.004 lower to 0.52 higher) |
⨁⨁⨁◯ Moderate |
Important |
| Attention (measured with TMT-B) (mixed physical activity intervention) | ||||||||||||
| 7 | Randomized controlled trials | Very seriousg | Not serious | Not serious | Not serious | None | 394 | 431 | – |
MD 6.77 (1.14 lower to 14.67 higher) |
⨁⨁◯◯ Low |
Important |
| Attention (measured with Stroop test) (mixed physical activity intervention) | ||||||||||||
| 6 | Randomized controlled trials | Not serious | Not serious | Not serious | Not serious | None | 271 | 271 | – |
SMD 0.19 SD higher (0.03 lower to 0.4 higher) |
⨁⨁⨁⨁ High |
Important |
| Immediate recall (mixed physical activity intervention) | ||||||||||||
| 9 | Randomized controlled trials | Not serious | Not serious | Not serious | Not serious | None | 396 | 395 | – |
0.11 higher (0.07 lower to 0.27 higher) |
⨁⨁⨁⨁ High |
Important |
| Verbal fluency (mixed physical activity intervention) | ||||||||||||
| 8 | Randomized controlled trials | Not serious | Seriousf | Not serious | Not serious | Publication bias strongly suspectedh | 477 | 476 | – |
SMD 0.12 SD higher (0.14 lower to 0.38 higher) |
⨁⨁◯◯ Low |
Important |
| Working memory (mixed physical activity intervention) | ||||||||||||
| 7 | Randomized controlled trials | Not serious | Not serious | Not serious | Not serious | None | 361 | 331 | – |
SMD 0.57 SD higher (1.21 lower to 2.34 higher) |
⨁⨁⨁⨁ High |
Important |
| Executive function (aerobic exercise) | ||||||||||||
| 4 | Randomized controlled trials | Not serious | Seriousf | Not serious | Not serious | None | 317 | 317 | – |
SMD 0.09 SD lower (0.38 lower to 0.2 higher) |
⨁⨁⨁◯ Moderate |
Important |
| Attention (aerobic exercise) | ||||||||||||
| 4 | Randomized controlled trials | Not serious | Not serious | Not serious | Not serious | None | 375 | 374 | – |
SMD 0.06 SD higher (0.72 lower to 0.3 higher) |
⨁⨁⨁⨁ High |
Important |
| Verbal fluency (aerobic exercise) | ||||||||||||
| 5 | Randomized controlled trials | Not serious | Not serious | Not serious | Not serious | None | 563 | 597 | – |
MD 0.16 lower (1.74 lower to 1.42 higher) |
⨁⨁⨁⨁ High |
Important |
| Delayed memory (mixed physical activity intervention) | ||||||||||||
| 10 | Randomized controlled trials | Not serious | Not serious | Not serious | Not serious | None | 534 | 535 | – |
SMD 0.002 SD higher (0.14 lower to 0.14 higher) |
⨁⨁⨁⨁ High |
Important |
CI Confidence interval, STM Short-Term Memory, SMD Standardized mean difference, SD Standard deviation, TMTB Trail Making Test B
aOne or more of the three criteria (randomization, masking, drop-out rate > 30%) is not met in > 30% of trials included
bI2 ≥ 75%
cEgger's test (p value) < 0.0001
dTotal sample size < 400 participants
eOne or more of the three criteria (randomization, masking, drop-out rate < 30%) is not met in 10–30% of trials included
fI2 between 50% and 75%