Cycling and cognition in middle-aged and older adults: A scoping review

Cognitive decline with aging is a population health issue. Cycling may help maintain, cognitive function and prevent cognitive decline in older adulthood. We conducted a scoping review to summarize and identify gaps in the literature examining cycling for transportation and/or recreation and their association with cognition in middle-aged and older adults. Nine bibliographic databases were searched (inception-March 2024) to identify all articles that reported on cycling for transportation, leisure outdoors, or cycling indoors, along a virtual bike path, and any cognitive outcomes among adults ≥ 45 years of age.We summarized article findings and associations narratively. Searching identified 5171 citations, and 23 articles were included examining apparently healthy and clinical populations. Cycling interventions included virtual cycling indoors (randomized controlled trials=10, quasi-experimental=5), cycling outdoors for recreation (quasi-experimental=3, cross-sectional=1), any reason (cohort=1, crosssectional=1), or transportation (simulation modelling=2). The most frequently examined cognitive outcome was executive function (n=15), followed by memory (n=9) and, global cognition (n=9). Most articles (70%) reported a statistically significant positive association between cycling and a cognitive outcome. Identified literature gaps include, a lack of sex- and gender-based analyses; robust study designs exploring cycling • Positive association (p <0.05) between cycling and cognition in adults ≥ 45 years of age • Only simulation modelling studies have examined cycling for transportation and cognition • Lack of sex and gender-based analyses of cycling and cognition • Longitudinal and experimental studies needed to examine cycling outdoors and cognition • Must test cycling's extra cognitive benefit over other physical activity/transport modes