Resistance training modestly improved working memory and flexibility in older adults

Design

Systematic review and meta-analysis of 17 randomised trials (22 reviewed)

Population

Community-dwelling adults aged 60 and over without cognitive impairment

Primary outcome

Executive functions: working memory, inhibitory control, cognitive flexibility

Effect

Working memory SMD 0.30 (95% CI 0.02–0.59); cognitive flexibility SMD −0.50 (−0.88 to −0.12)

This meta-analysis pooled 17 randomised trials of resistance training in community-dwelling adults aged 60 and over without cognitive impairment, looking at executive functions: working memory, inhibitory control and cognitive flexibility.

Compared with control conditions, resistance training produced small to moderate improvements in working memory and cognitive flexibility, but not in inhibitory control. Compared with other forms of exercise, it was no better on any measure.

The certainty of evidence was low, risk of bias was high, and the training programmes varied widely.

The practical message is that strength training belongs in the exercise advice given to older adults for its proven effects on muscle, function and falls, and may help some aspects of thinking as well. Any exercise appears to help, so the best programme is the one the person will keep doing.

• Recommend resistance training twice a week to older adults who can do it safely.
• Combine strength with balance and aerobic activity where possible.
• Choose the form of exercise the person is most likely to sustain.
• Do not present strength training as a dementia prevention treatment.

Why it matters

It adds a possible cognitive reason to the strong physical case for strength training in later life.

Don't overread it

Low-certainty evidence with high risk of bias; it does not show resistance training prevents dementia.

The statistics, in plain English

A standardised mean difference of 0.30 is a small effect and 0.50 a moderate one. The interval for working memory (0.02 to 0.59) only just excludes no effect. Low certainty means future trials could change these estimates.

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