Efficacy of Aerobic Versus Non-aerobic Exercise in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis Based on RCTs

Abstract Background and Objectives: This study reviewed relevant randomized controlled trials (RCTs) to meta-analyze the effects of aerobic versus non-aerobic exercise in patients with mild cognitive impairment (MCI). Methods: RCTs comparing aerobic and non-aerobic exercise on cognitive function in patients with MCI were identified through searches of four databases—PubMed, Web of Science, MEDLINE, and the Cochrane Library—from January 2000 to July 2025, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Effect sizes were assessed using the mean difference (MD) and 95% confidence interval (CI). Results: A total of 15 studies were included, which comprised 1,192 older adults with MCI. Compared with the non-aerobic exercise group, the aerobic exercise group had greater peak oxygen uptake (MD = 3.99 ml/kg/min; 95% CI: (2.01, 5.96); P < 0.001), shorter trail making test-B (TMT-B) completion time (MD = –9.57 s; 95% CI: (–15.43, –3.70); P = 0.001), and improved delayed recall (MD = 0.90; 95% CI: (0.47, 1.33); P < 0.001). No significant differences were observed in the Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) scores (both P > 0.05). Conclusions: Aerobic exercise improves cognitive flexibility, cardiorespiratory fitness, and information consolidation and extraction in older adults with MCI compared with non-aerobic exercise, but it does not significantly affect overall cognitive function.