Liu · Frontiers in physiology 2026 · Systematic review and Bayesian network meta-analysis · n=47 studies (1815 participants)

Optimizing exercise modalities to enhance brain-derived neurotrophic factor levels in older adults: a Bayesian network and dose-response meta-analysis.

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Level 1 - systematic review of randomized trials

Systematic review and Bayesian network meta-analysis of randomized controlled trials

PubMed 42528705 · doi:10.3389/fphys.2026.1777058 · record verified 2026-08-28

What was done

A multilevel Bayesian network and dose-response meta-analysis of randomized controlled trials (searched through April 2025 across PubMed, Embase, Web of Science, and Cochrane Library) evaluated the comparative effects of exercise modalities, doses, and intensities on brain-derived neurotrophic factor (BDNF) levels in older adults.

What was found

Across 47 RCTs with 1,815 participants, aquatic exercise had the highest point estimate (SMD = 1.00), followed by mind-body exercise (SMD = 0.61) and mixed exercise (SMD = 0.30). Aerobic, resistance, and combined aerobic-resistance exercises also improved BDNF levels. High-intensity interval training (HIIT) was uncertain in primary analysis. Dose-response relationships were non-linear, and advanced age diminished intervention effectiveness.

Why it matters

This review provides comparative rankings and dose-response characteristics across diverse exercise regimens to guide physical activity interventions aimed at mitigating age-related neurotrophic decline.

Limits

Aquatic exercise and HIIT estimates were based on sparse evidence and remain preliminary. The abstract omits confidence/credible intervals, specific baseline cognitive or physical status of participants, BDNF assay types (serum vs. plasma), and clinical cognitive outcomes.

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