The effects of chronic exercise interventions on executive function in healthy older adults and optimal training characteristics: A systematic review based on randomized controlled trials

In an aging society, mitigating cognitive decline is a critical challenge. However, reviews on exercise effects and optimal parameters for healthy older adults remain limited. This systematic review evaluated the effects of chronic exercise interventions on executive function in healthy older adults. Following PRISMA guidelines, we registered the review with PROSPERO (CRD42024618878) and searched Scopus, PubMed, EBSCOhost, and other sources for studies published before December 2024. We included randomized controlled trials involving adults aged ≥60, with pre- and post-intervention executive function measures, comparing chronic exercise with non-exercise controls. Studies involving physical or neurological conditions or acute interventions were excluded. Risk of bias was assessed via Cochrane RoB 2 tool. Data synthesis followed the PICOS framework, with narrative and quantitative summaries. A total of 76 studies (n = 7101; 69 % female) met inclusion criteria. Of these, 71 % (54/76) showed significant improvements in executive function. Aerobic, resistance, and coordination exercises had similar effects (64 %–71 %). Optimal parameters included short session duration (≤45 min), high frequency (5–7/week), long-term duration (25–48 weeks), and vigorous intensity. High adherence appeared to enhance outcomes. These findings support chronic exercise as an effective strategy to improve executive function in healthy older adults and highlight the importance of exercise type, dosage, and adherence in promoting healthy aging.