Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review

İsa Yeşilyurt; Sümeyra Altun Yeşilyurt

Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review

Abstract

Introduction: The objective of this systematic review is to comparatively evaluate the effects of aerobic (AE), resistance (RE), and combined exercise (CE) modalities on cognitive function in adults diagnosed with Alzheimer’s disease, dementia, and mild cognitive impairment (MCI). Materials and Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive literature search was performed across Web of Science, Scopus, and PubMed databases. A total of 15 randomized controlled trials meeting the inclusion criteria were analyzed. The effects of AE, RE, and CE on global cognitive function, memory, executive functions, and activities of daily living were synthesized based on the methodological quality of the included studies. Results: The reviewed studies suggest that exercise is generally associated with improvements or a slower rate of decline in cognitive performance. AE was frequently linked to favorable changes in memory-related outcomes and hippocampal integrity. RE is commonly associated with improvements in executive-related domains, such as praxis and motor planning. BDNF and IGF-1 may mediate the effects of exercise on cognitive function. Among individuals with dementia, CE programs tended to demonstrate more consistent effects on global cognitive function and activities of daily living compared with single-modality interventions, although findings varied across studies. Conclusion: AE and RE support cognitive health through distinct neurobiological mechanisms. Particularly in dementia and MCI populations, combined exercise appears to have more consistent effects on global cognitive function and activities of daily living than single-modality interventions. Future research should focus on standardized protocols to establish optimal dose-response relationships.

Keywords

Supporting Institution

This study received no financial support.

Ethical Statement

This study is a review of previously published literature; therefore, ethical approval and informed consent were not required

References

Barha, C. K., Falck, R. S., Best, J. R., Nagamatsu, L. S., Hsiung, G.Y. R., Sheel, A. W., Hsu, C. L., Kramer, A. F., Voss, M. W., Erickson, K. I., Davis, J. C., Shoemaker, J. K., Boyd, L., Crockett, R. A., ten Brinke, L., Bherer, L., Singer, J., Galea, L. A. M., Jacova, C., … Liu-Ambrose, T. (2022). Reshaping the path of mild cognitive impairment by refining exercise prescription: a study protocol of a randomized controlled trial to understand the “what,” “for whom,” and “how” of exercise to promote cognitive function. Trials, 23(1), 766. https://doi.org/10.1186/s13063-022-06699-7
Bossers, W. J. R., van der Woude, L. H. V., Boersma, F., Hortobágyi, T., Scherder, E. J. A., & van Heuvelen, M. J. G. (2015). A 9-week aerobic and strength training program improves cognitive and motor function in patients with dementia: a randomized, controlled trial. The American Journal of Geriatric Psychiatry, 23(11), 1106–1116. https://doi.org/10.1016/j.jagp.2014.12.191
Bossers, W. J. R., van der Woude, L. H. V., Boersma, F., Hortobágyi, T., Scherder, E. J. A., & van Heuvelen, M. J. G. (2016). Comparison of effect of two exercise programs on activities of daily living in individuals with dementia: a 9‐week randomized, controlled trial. Journal of the American Geriatrics Society, 64(6), 1258–1266. https://doi.org/10.1111/jgs.14160
Davis, J. C., Bryan, S., Marra, C. A., Hsiung, G.Y. R., & Liu-Ambrose, T. (2015). Challenges with cost-utility analyses of behavioural interventions among older adults at risk for dementia. British Journal of Sports Medicine, 49(20), 1343–1347. https://doi.org/10.1136/bjsports-2013-092743
Huang, C. H., Umegaki, H., Makino, T., Uemura, K., Hayashi, T., Kitada, T., Inoue, A., Shimada, H., & Kuzuya, M. (2021). Effect of various exercises on intrinsic capacity in older adults with subjective cognitive concerns. Journal of the American Medical Directors Association, 22(4), 780-786.e2. https://doi.org/10.1016/j.jamda.2020.06.048
Iuliano, E., di Cagno, A., Aquino, G., Fiorilli, G., Mignogna, P., Calcagno, G., & Di Costanzo, A. (2015). Effects of different types of physical activity on the cognitive functions and attention in older people: A randomized controlled study. Experimental Gerontology, 70, 105–110. https://doi.org/10.1016/j.exger.2015.07.008
Komulainen, P., Tuomilehto, J., Savonen, K., Männikkö, R., Hassinen, M., Lakka, T. A., Hänninen, T., Kiviniemi, V., Jacobs, D. R., Kivipelto, M., & Rauramaa, R. (2021). Exercise, diet, and cognition in a 4-year randomized controlled trial: Dose-Responses to Exercise Training (DR’s EXTRA). The American Journal of Clinical Nutrition, 113(6), 1428–1439. https://doi.org/10.1093/ajcn/nqab018
Krootnark, K., Chaikeeree, N., Saengsirisuwan, V., & Boonsinsukh, R. (2024). Effects of low-intensity home-based exercise on cognition in older persons with mild cognitive impairment: a direct comparison of aerobic versus resistance exercises using a randomized controlled trial design. Frontiers in Medicine, 11, 1392429. https://doi.org/10.3389/fmed.2024.1392429

Liu, I.-T., Lee, W.-J., Lin, S.-Y., Chang, S.-T., Kao, C.-L., & Cheng, Y.-Y. (2020). Therapeutic effects of exercise training on elderly patients with dementia: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 101(5), 762–769. https://doi.org/10.1016/j.apmr.2020.01.012
Luo, G., Zhang, J., Song, Z., Wang, Y., Wang, X., Qu, H., Wang, F., Liu, C., & Gao, F. (2023). Effectiveness of non-pharmacological therapies on cognitive function in patients with dementia—a network meta-analysis of randomized controlled trials. Frontiers in Aging Neuroscience, 15, 1131744. https://doi.org/10.3389/fnagi.2023.1131744
Lv, S., Wang, Q., Liu, W., Zhang, X., Cui, M., Li, X., & Xu, Y. (2023). Comparison of various exercise interventions on cognitive function in Alzheimer’s patients: a network meta-analysis. Archives of Gerontology and Geriatrics, 115, 105113. https://doi.org/10.1016/j.archger.2023.105113
Makino, T., Umegaki, H., Ando, M., Cheng, X. W., Ishida, K., Akima, H., Oshida, Y., Yoshida, Y., Uemura, K., Shimada, H., & Kuzuya, M. (2021). Effects of aerobic, resistance, or combined exercise training among older adults with subjective memory complaints: a randomized controlled trial. Journal of Alzheimer’s Disease, 82(2), 701–717. https://doi.org/10.3233/JAD-210047
Martín-Rodríguez, A., Dalamitros, A. A., Madrigal-Cerezo, R., Sánchez-Conde, P., Clemente Suárez, V. J., & Tornero Aguilera, J. F. (2025). Move to remember: the role of physical activity and exercise in preserving and enhancing cognitive function in aging—a narrative review. Geriatrics, 10(6), 143. https://doi.org/10.3390/geriatrics10060143
Oporto-Colicoi, V., Sepúlveda-Lara, A., Marzuca-Nassr, G. N., & Sepúlveda-Figueroa, P. (2025). Mild cognitive impairment and sarcopenia: effects of resistance exercise training on neuroinflammation, cognitive performance, and structural brain changes. International Journal of Molecular Sciences, 26(22), 11036. https://doi.org/10.3390/ijms262211036
Papatsimpas, V., Vrouva, S., Papathanasiou, G., Papadopoulou, M., Bouzineki, C., Kanellopoulou, S., Moutafi, D., & Bakalidou, D. (2023). Does therapeutic exercise support improvement in cognitive function and instrumental activities of daily living in patients with mild alzheimer’s disease? a randomized controlled trial. Brain Sciences, 13(7), 1112. https://doi.org/10.3390/brainsci13071112
Resende-Silva, S., de Resende-Neto, A. G., Vasconcelos, A. B. S., Pereira-Monteiro, M. R., Pantoja-Cardoso, A., Santana Santos, L. E., Carvalho Lima, N. B., Jesus Santos, J. L. de, Aragão-Santos, J. C., Schimieguel, D. M., Santos, J. R. dos, & Da Silva-Grigoletto, M. E. (2025). Functional training improves cognitive function, functional fitness, and BDNF levels in older women with mild cognitive impairment: a randomized controlled trial. Frontiers in Physiology, 16, 1638590. https://doi.org/10.3389/fphys.2025.1638590
Silva, A. F., Clemente, F. M., Roriz, M. S., Azevedo, J. A., Jovanovic, O., Adamovic, M., Bozic, A., & Silva, R. (2025). The effect of aerobic or strength training in elderly with cognitive decline: The Fit4Alz project. Journal of Sports Science and Medicine, 24, 172–186. https://doi.org/10.52082/jssm.2025.172
Silva, A. F., Assis, G., Silva, R. M., Murawska-Ciałowicz, E., Zurek, G., Carvalho, J., Roriz, M. S., Azevedo, J. A., Sampaio, A., Bento, T., Jovanovic, O., Adamovic, M., Grieco, S., Germini, R., & Clemente, F. M. (2025). The differential effect of strength, cognitive and aerobic training combinations on cognitive performance and functional abilities in elderly with cognitive decline: The Fit4Alz project. The Journal of Prevention of Alzheimer’s Disease, 12(8), 100267. https://doi.org/10.1016/j.tjpad.2025.100267
Szabo-Reed, A., Clutton, J., White, S., Van Sciver, A., White, D., Morris, J., Martin, L., Lepping, R., Shaw, A., Puchalt, J. P., Montgomery, R., Mahnken, J., Washburn, R., Burns, J., & Vidoni, E. D. (2022). Combined exercise trial (COMET) to improve cognition in older adults: rationale and methods. Contemporary Clinical Trials, 118, 106805. https://doi.org/10.1016/j.cct.2022.106805
ten Brinke, L. F., Bolandzadeh, N., Nagamatsu, L. S., Hsu, C. L., Davis, J. C., Miran-Khan, K., & Liu-Ambrose, T. (2015). Aerobic exercise increases hippocampal volume in older women with probable mild cognitive impairment: a 6-month randomised controlled trial. British Journal of Sports Medicine, 49(4), 248–254. https://doi.org/10.1136/bjsports-2013-093184
Tsai, C.L., Ukropec, J., Ukropcová, B., & Pai, M.-C. (2018). An acute bout of aerobic or strength exercise specifically modifies circulating exerkine levels and neurocognitive functions in elderly individuals with mild cognitive impairment. NeuroImage: Clinical, 17, 272–284. https://doi.org/10.1016/j.nicl.2017.10.028
Wewege, M. A., Thom, J. M., Rye, K. A., & Parmenter, B. J. (2018). Aerobic, resistance, or combined training: a systematic review and meta-analysis of exercise to reduce cardiovascular risk in adults with metabolic syndrome. Atherosclerosis, 274, 162–171. https://doi.org/10.1016/j.atherosclerosis.2018.05.002
Wu, T., Wang, X., Xu, Y., Zhang, C., Huang, M., & Li, H. (2025). The effect of resistance training for older adults with cognitive frailty: a randomized controlled trial. BMC Geriatrics, 25(1), 681. https://doi.org/10.1186/s12877-025-06311-y
Yu, F., Todd, M., Salisbury, D., Maxfield, M., Pruzin, J., Joseph, R. P., Su, Y., Li, D., Baena, E., & Coon, D. (2025). Precision exercise in older adults with early Alzheimer’s disease: the study protocol of the FIT-AD sequential, multiple assignment, randomized trial (SMART). Trials, 26(1), 416. https://doi.org/10.1186/s13063-025-09040-0
Zhang, M., Fang, W., Wang, J. (2025). Effects of human concurrent aerobic and resistance training on cognitive health: a systematic review with meta-analysis. Int J Clin Health Psychol 25(1):100559. doi: 10.1016/j.ijchp.2025.100559.

Details

Primary Language

English

Subjects

Neurosciences (Other), Exercise Physiology

Journal Section

Review

Authors

İsa Yeşilyurt ^*
0000-0002-2164-4580
Türkiye

Sümeyra Altun Yeşilyurt
0009-0006-5782-5830
Türkiye

Publication Date

January 30, 2026

Submission Date

January 5, 2026

Acceptance Date

January 16, 2026

Published in Issue

Year 2026 Volume: 2 Number: 1

IZ

https://izlik.org/JA63YS23CC

Cite

RIS / Bibtex

APA

Yeşilyurt, İ., & Altun Yeşilyurt, S. (2026). Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review. Anatolian Journal of Medical Sciences, 2(1), 1-9. https://izlik.org/JA63YS23CC

AMA

1.Yeşilyurt İ, Altun Yeşilyurt S. Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review. Anatolian Journal of Medical Sciences. 2026;2(1):1-9. https://izlik.org/JA63YS23CC

Chicago

Yeşilyurt, İsa, and Sümeyra Altun Yeşilyurt. 2026. “Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review”. Anatolian Journal of Medical Sciences 2 (1): 1-9. https://izlik.org/JA63YS23CC.

EndNote

Yeşilyurt İ, Altun Yeşilyurt S (January 1, 2026) Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review. Anatolian Journal of Medical Sciences 2 1 1–9.

IEEE

[1]İ. Yeşilyurt and S. Altun Yeşilyurt, “Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review”, Anatolian Journal of Medical Sciences, vol. 2, no. 1, pp. 1–9, Jan. 2026, [Online]. Available: https://izlik.org/JA63YS23CC

ISNAD

Yeşilyurt, İsa - Altun Yeşilyurt, Sümeyra. “Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review”. Anatolian Journal of Medical Sciences 2/1 (January 1, 2026): 1-9. https://izlik.org/JA63YS23CC.

JAMA

1.Yeşilyurt İ, Altun Yeşilyurt S. Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review. Anatolian Journal of Medical Sciences. 2026;2:1–9.

MLA

Yeşilyurt, İsa, and Sümeyra Altun Yeşilyurt. “Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review”. Anatolian Journal of Medical Sciences, vol. 2, no. 1, Jan. 2026, pp. 1-9, https://izlik.org/JA63YS23CC.

Vancouver

1.İsa Yeşilyurt, Sümeyra Altun Yeşilyurt. Aerobic, Resistance, or Combined Exercise on Cognitive Functions: A Systematic Review. Anatolian Journal of Medical Sciences [Internet]. 2026 Jan. 1;2(1):1-9. Available from: https://izlik.org/JA63YS23CC