Efficacy of Aerobic Versus Non-aerobic Exercise in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis Based on RCTs.

BACKGROUND AND OBJECTIVES: This study reviewed relevant randomized controlled trials (RCTs) to meta-analyze the effects of aerobic versus non-aerobic exercise in patients with mild cognitive impairment (MCI). METHODS: RCTs comparing aerobic and non-aerobic exercise on cognitive function in patients with MCI were identified through searches of four databases-PubMed, Web of Science, MEDLINE, and the Cochrane Library-from January 2000 to July 2025, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Effect sizes were assessed using the mean difference (MD) and 95% confidence interval (CI). RESULTS: A total of 15 studies were included, which comprised 1,192 older adults with MCI. Compared with the non-aerobic exercise group, the aerobic exercise group had greater peak oxygen uptake (MD = 3.99 ml/kg/min; 95% CI: (2.01, 5.96); P < 0.001), shorter trail making test-B (TMT-B) completion time (MD = -9.57 s; 95% CI: (-15.43, -3.70); P = 0.001), and improved delayed recall (MD = 0.90; 95% CI: (0.47, 1.33); P < 0.001). No significant differences were observed in the Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) scores (both P > 0.05). CONCLUSIONS: Aerobic exercise improves cognitive flexibility, cardiorespiratory fitness, and information consolidation and extraction in older adults with MCI compared with non-aerobic exercise, but it does not significantly affect overall cognitive function.