An umbrella review of randomized control trials on the effects of physical exercise on cognition

Luis F. Ciria (), Rafael Román-Caballero, Miguel A. Vadillo, Darias Holgado, Antonio Luque-Casado, Pandelis Perakakis and Daniel Sanabria ()
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Luis F. Ciria: University of Granada
Rafael Román-Caballero: University of Granada
Miguel A. Vadillo: Autonomous University of Madrid
Darias Holgado: University of Granada
Antonio Luque-Casado: Rey Juan Carlos University
Pandelis Perakakis: Complutense University of Madrid
Daniel Sanabria: University of Granada

Nature Human Behaviour, 2023, vol. 7, issue 6, 928-941

Abstract: Abstract Extensive research links regular physical exercise to an overall enhancement of cognitive function across the lifespan. Here we assess the causal evidence supporting this relationship in the healthy population, using an umbrella review of meta-analyses limited to randomized controlled trials (RCTs). Despite most of the 24 reviewed meta-analyses reporting a positive overall effect, our assessment reveals evidence of low statistical power in the primary RCTs, selective inclusion of studies, publication bias and large variation in combinations of pre-processing and analytic decisions. In addition, our meta-analysis of all the primary RCTs included in the revised meta-analyses shows small exercise-related benefits (d = 0.22, 95% confidence interval 0.16 to 0.28) that became substantially smaller after accounting for key moderators (that is, active control and baseline differences; d = 0.13, 95% confidence interval 0.07 to 0.20), and negligible after correcting for publication bias (d = 0.05, 95% confidence interval −0.09 to 0.14). These findings suggest caution in claims and recommendations linking regular physical exercise to cognitive benefits in the healthy human population until more reliable causal evidence accumulates.

Date: 2023
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DOI: 10.1038/s41562-023-01554-4

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