Intervention-Type-Specific Effects on Healthy Aging of Older Adults with Cognitive Impairment: A Systematic Review and Meta-Analysis

Abstract Background and Objectives Healthy aging among older adults with cognitive impairment requires preserving physical, cognitive, and psychosocial functioning to sustain their independence and quality of life. However, existing interventions vary in design, delivery format, and composition, and evidence regarding their effectiveness across these three core domains remains inconsistent. This study aimed to identify the most effective intervention types for specific domains of healthy aging. Research Design and Methods Five electronic databases were searched for studies published from October 2015 to June 2026. Randomized controlled trials reporting at least two outcomes—among physical capability, cognitive function, or psychosocial well-being—were reviewed. Risk of bias was assessed using the Cochrane Risk-of-Bias 2 tool. A dependency-aware multilevel random-effects meta-analysis with trial-clustered robust inference was conducted in R, supplemented by moderator tests, prediction intervals, sensitivity analyses, reporting-bias assessments, and GRADE evaluations. Results Multicomponent interventions were associated with beneficial effects on cognitive and psychosocial outcomes, whereas group-based interventions showed beneficial effects across all three domains and a significantly greater effect on cognitive function than individually delivered interventions. Despite substantial heterogeneity and wide prediction intervals, these findings were generally robust across sensitivity analyses. Discussion and Implications The observed advantages of group-based delivery, particularly for cognitive function, and multicomponent approaches for cognitive and psychosocial outcomes highlight the domain-specific nature of intervention effects. These findings support tailoring intervention delivery and component configuration to the targeted domain rather than applying a uniform approach to healthy aging among older adults with cognitive impairment.