Effects of motor-cognitive dual-task training on executive function in older adults with mild cognitive impairment: A multilevel dose-response meta-analysis.
- 1School of Physical Education and Sport Science, Fujian Normal University, No. 18, Wulongjiang Middle Avenue, Shangjie Town, Minhou County, Fuzhou, 350117, China.
- 2School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing, 100191, China.
- 3Department of Physical Education, Shanghai Jiao Tong University, Shanghai, 200240, China.
Abstract
To assess the effects of motor-cognitive dual-task training (MCDTT) on inhibitory control, working memory, and cognitive flexibility in older adults with mild cognitive impairment (MCI), and explore potential moderators and dose-response relationships. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, we searched PubMed, Web of Science, Embase, the Cochrane Library, and China National Knowledge Infrastructure (CNKI) for eligible randomized controlled trials (RCTs). We pooled Hedges' g-corrected standardized mean differences (SMDs) using three-level random-effects models. Risk of bias and evidence certainty were assessed with the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Exploratory analyses comprised categorical subgroups, univariable three-level meta-regression, quadratic meta-regression, and Bayesian cumulative-dose modeling. Sensitivity analyses examined restrictions to selected outcome measures, the exclusion of mixed cognitive-risk cohorts, and comparator activity. Twenty-one trials reported 1335 participants, including two mixed cognitive-risk cohorts. Pooled effects favored MCDTT for inhibitory control (SMD = 0.33, 95% confidence interval (CI) 0.12 to 0.53; P_effect = 0.002), working memory (SMD = 0.57, 95% CI 0.33 to 0.81; P_effect<0.001), and cognitive flexibility (SMD = 0.32, 95% CI 0.13 to 0.52; P_effect = 0.001). The certainty of GRADE evidence for all three outcomes was low, heterogeneity was substantial, and prediction intervals crossed zero. Working-memory and cognitive-flexibility effects remained positive after restriction to Digit Span Backward/Sequencing and Trail Making Test Part B, respectively; the Stroop-family restriction yielded an inhibitory-control estimate near zero. Excluding mixed cohorts preserved positive average effects. Restricting analyses to active comparators also retained positive effects in all three domains. Categorical subgroup patterns were not corroborated by the 24 univariable moderator tests. No stable cumulative-dose optimum was identified within the evaluated ranges. MCDTT shows promise for supporting executive function in older adults with MCI. The findings distinguish domain-specific responses and inform future comparative and dose-ranging trials. Low evidence certainty and exploratory moderator results warrant individualized application rather than a fixed intervention ranking or dose prescription.
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BibTeX
@article{yin2026effects,
title = {{Effects of motor-cognitive dual-task training on executive function in older adults with mild cognitive impairment: A multilevel dose-response meta-analysis.}},
author = {Xinyuan Yin and Zhikai Qin and Shengyu Dai and Xiaoke Zhong and Xinbi Zhang and Yingying Wang and Pingxue Qiu and Changhao Jiang},
journal = {Journal of exercise science and fitness},
year = {2026},
month = oct,
doi = {10.1016/j.jesf.2026.200532},
url = {https://europepmc.org/article/MED/42999655},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Effects of motor-cognitive dual-task training on executive function in older adults with mild cognitive impairment: A multilevel dose-response meta-analysis.
AU - Xinyuan Yin
AU - Zhikai Qin
AU - Shengyu Dai
AU - Xiaoke Zhong
AU - Xinbi Zhang
AU - Yingying Wang
AU - Pingxue Qiu
AU - Changhao Jiang
PY - 2026
DA - 2026/10/27
JO - Journal of exercise science and fitness
DO - 10.1016/j.jesf.2026.200532
UR - https://europepmc.org/article/MED/42999655
AB - To assess the effects of motor-cognitive dual-task training (MCDTT) on inhibitory control, working memory, and cognitive flexibility in older adults with mild cognitive impairment (MCI), and explore potential moderators and dose-response relationships. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, we searched PubMed, Web of Science, Embase, the Cochrane Library, and China National Knowledge Infrastructure (CNKI) for eligible randomized controlled trials (RCTs). We pooled Hedges' g-corrected standardized mean differences (SMDs) using three-level random-effects models. Risk of bias and evidence certainty were assessed with the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Exploratory analyses comprised categorical subgroups, univariable three-level meta-regression, quadratic meta-regression, and Bayesian cumulative-dose modeling. Sensitivity analyses examined restrictions to selected outcome measures, the exclusion of mixed cognitive-risk cohorts, and comparator activity. Twenty-one trials reported 1335 participants, including two mixed cognitive-risk cohorts. Pooled effects favored MCDTT for inhibitory control (SMD = 0.33, 95% confidence interval (CI) 0.12 to 0.53; P_effect = 0.002), working memory (SMD = 0.57, 95% CI 0.33 to 0.81; P_effect<0.001), and cognitive flexibility (SMD = 0.32, 95% CI 0.13 to 0.52; P_effect = 0.001). The certainty of GRADE evidence for all three outcomes was low, heterogeneity was substantial, and prediction intervals crossed zero. Working-memory and cognitive-flexibility effects remained positive after restriction to Digit Span Backward/Sequencing and Trail Making Test Part B, respectively; the Stroop-family restriction yielded an inhibitory-control estimate near zero. Excluding mixed cohorts preserved positive average effects. Restricting analyses to active comparators also retained positive effects in all three domains. Categorical subgroup patterns were not corroborated by the 24 univariable moderator tests. No stable cumulative-dose optimum was identified within the evaluated ranges. MCDTT shows promise for supporting executive function in older adults with MCI. The findings distinguish domain-specific responses and inform future comparative and dose-ranging trials. Low evidence certainty and exploratory moderator results warrant individualized application rather than a fixed intervention ranking or dose prescription.
SN - 1728-869X
SN - 2226-5104
ER -