Effects of different non-pharmacological interventions on executive function in healthy older people: A systematic review and network meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and network meta-analysis of randomized controlled trials
PubMed 41576774 · doi:10.1016/j.archger.2026.106141
What was done
A systematic review and network meta-analysis evaluated the comparative effectiveness of 11 non-pharmacological interventions on overall executive function and its subdomains (working memory, cognitive flexibility, and inhibition) in healthy older adults aged 60 and older. Searches across PubMed, Cochrane, Embase, and Web of Science up to February 17, 2025, identified randomized controlled trials (RCTs). Risk of bias was evaluated with RoB 2 and confidence via CINeMA; analyses were run using the R package "netmeta". A total of 115 RCTs with 16,824 participants were included.
What was found
Network meta-analysis showed distinct intervention advantages across subdomains: - Dance showed favorable outcomes for overall executive function (standardized mean difference [SMD] = 0.82, 95% CI: 0.40 to 1.24) and cognitive flexibility (SMD = 0.96, 95% CI: 0.50 to 1.43). - Resistance training had the greatest improvement for working memory (SMD = 0.86, 95% CI: 0.51 to 1.20). - Computerized cognitive training showed a positive effect on inhibition (SMD = 0.48, 95% CI: 0.28 to 0.68).
Why it matters
This review provides an evidence-based ranking demonstrating that specific non-pharmacological interventions target distinct executive function subdomains in healthy older adults, supporting tailored intervention selection rather than generic approaches.
Limits
The study is restricted to healthy older adults aged 60 and older, limiting generalizability to populations with cognitive impairment or dementia. The abstract does not disclose the specific CINeMA confidence ratings per comparison, details on intervention duration or intensity, adherence rates, or long-term persistence of cognitive benefits.