The Effect of Pure Cognitive Training on Gait and Balance in Older People: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Growing evidence suggests that physical and cognitive function, both of which decline with aging, are significantly interrelated. While numerous studies have investigated the effect of physical exercise on cognitive function, relatively few have examined the impact of cognitive training on physical performance.
Objective:
this review aims to summarize the effects of pure cognitive training on mobility and balance in older adults.
Methods:
Electronic databases (PubMed, Embase, CINAHL, and PsycINFO) were searched in February 2025. Randomized controlled trials that investigated the effect of pure cognitive training on balance and gait among older adults were included. The PEDro scale was used to evaluate the methodological quality. The level of evidence for available outcomes was rated by the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. Meta-analysis and sensitivity analysis of studies with high methodological quality were performed if three or more studies were obtained.
Results:
Fourteen studies were eventually included. The methodological qualities of eight studies were rated as good, while six studies were rated as fair. Meta-analysis of high methodological quality studies showed that pure cognitive training has a significant effect on cognitive-motor dual-task gait speed (SMD=0.39, 95%CI= 0.04 to 0.75, n=376, Moderate-quality), but not on single-task gait speed (SMD=0.12, 95%CI=-0.05 to 0.30, n=506, Moderate-quality). No significant improvements were found in functional mobility (SMD = 0.29, 95%CI = -0.60 to 1.18, n=566, Low-quality) and balance (SMD = 0.18, 95%CI= -0.34 to 0.69, n=139, Very low-quality).
Conclusions:
Cognitive training does not improve balance and mobility in single-task conditions, but can improve walking speed in cognitive-motor dual-task conditions in older people. A cognitive training protocol targeting executive function, consisting of 40 to 60-minute sessions conducted 2-3 times per week over a period of 8-10 weeks, has been shown to be effective. Clinical Trial: Registration of the protocol in PROSPERO (CRD42023401100)
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