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Randomized controlled trials published up to May 2025 were identified from four databases (Cochrane Library, PubMed, EMBASE, and Web of Science). Aerobic, resistance, and combined exercise interventions were included. Study quality was assessed using the Cochrane RoB 2 tool, and random-effects meta-analyses were conducted. Fourteen studies involving 1,097 participants were included. The meta-analysis indicated that aerobic exercise was mainly associated with improvements in cognitive outcomes, whereas resistance exercise primarily enhanced muscle strength and physical performance. Interventions combining aerobic and resistance components showed benefits across both cognitive and muscle function domains. Although the included studies were few and heterogeneous, the overall pattern suggests potential modality-specific effects, whereby aerobic exercise may support cognitive function, resistance exercise may enhance muscle strength and physical performance, and combined exercise may provide benefits for both cognition and muscle function in older adults with mild to moderate cognitive impairment or dementia. However, the certainty of evidence ranged from low to very low, and these findings should therefore be interpreted with caution. These findings highlight the value of selecting exercise modalities based on targeted functional goals.<\/jats:p>\n                  <jats:p>\n                    <jats:italic>PROSPERO registration<\/jats:italic>\n                    : CRD420251051222\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-48294-9","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T07:27:58Z","timestamp":1777274878000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of exercise modalities on cognitive and muscle function in older adults with cognitive impairment: a systematic review and meta-analysis"],"prefix":"10.1038","volume":"16","author":[{"given":"Yu Hyeon","family":"Choe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun-Jeong","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youngju","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Ho","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju-Hee","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo-Bum","family":"Kwak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"48294_CR1","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","volume":"396","author":"G Livingston","year":"2020","unstructured":"Livingston, G. et al. 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