{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:05:12Z","timestamp":1783926312817,"version":"3.55.0"},"reference-count":96,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Non-pharmacological interventions like physical activity may preserve cognition, slow its decline, and reduce behavioral\/psychological symptoms associated with cognitive impairment (CI). This review synthesizes evidence on swimming\u2019s effects on cognitive functioning in older adults and additionally reports on other health outcomes and the drivers, facilitators, and barriers for participation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four databases (Medline, APA PsycINFO, CINAHL, Scopus) were searched for studies on swimming, cognitive health and wellbeing, and dementia. English articles reporting impacts were included. A structured coding framework guided data extraction; two researchers coded the studies (81% agreement). Discrepancies were resolved by a tiebreaker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen studies met the inclusion criteria (out of 3,915 articles), published between 2007 and 2019 across 11 countries. Two were randomized control trials (RCT), and the majority were mostly cross-sectional (6 studies) of moderate-high quality. Older adults with dementia were mostly considered in the studies, with the majority of interventions being instructor-led programs in public pools. Six studies reported improvement in cognitive functioning associated with swimming. Additional behavioral and psychological benefits (e.g., improved attention, depression, anxiety) were noted, with physiological improvements being the most consistently noted (e.g., cardiorespiratory fitness, strength). Reported drivers for participating in swimming included improving cognitive wellbeing, pleasure\/fun, and clinician recommendations. Facilitators\/barriers were mapped using the Socioecological Model. Participation was largely influenced by intrapersonal factors acting as both facilitators (e.g., swimming pleasure\/enjoyment) and barriers (e.g., fluctuating psychological symptoms).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Swimming is a non-pharmacological intervention that demonstrates promising benefits for older adults\u2019 cognitive functioning in addition to other physiological and psychological benefits. It is especially valuable in countries\/regions where climate conditions limit year-round outdoor activity. More rigorous and clearly defined research designs (e.g., defined intensity\/duration\/delivery approach) are needed to generate more robust evidence on differential benefits across CI severity levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1839102","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T06:11:11Z","timestamp":1783923071000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of swimming on cognitive and health outcomes in older adults and insights into participation facilitators and barriers: a systematic review"],"prefix":"10.3389","volume":"13","author":[{"given":"Mirou","family":"Jaana","sequence":"first","affiliation":[{"name":"Telfer School of Management, University of Ottawa","place":["Ottawa, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Cruise","sequence":"additional","affiliation":[{"name":"Telfer School of Management, University of Ottawa","place":["Ottawa, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Georges","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Universit\u00e9 de Sherbrooke","place":["Sherbrooke, QC, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"B1","unstructured":"Ageing and Health.\n          \n          2021"},{"key":"B2","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1186\/s12877-021-02156-3","article-title":"Exploring the effect of professional experience on knowledge towards geriatric care among nurses working in adult care units.","volume":"21","author":"Amsalu","year":"2021","journal-title":"BMC Geriatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"84","DOI":"10.3390\/geriatrics5040084","article-title":"Global cognitive impairment prevalence and incidence in community dwelling older adults-a systematic review.","volume":"5","author":"Pais","year":"2020","journal-title":"Geriatrics (Basel)"},{"key":"B4","volume-title":"Cognitive Impairment: A Call for Action, Now!.","year":"2011"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1002\/alz.13016","article-title":"2023 Alzheimer\u2019s disease facts and figures.","volume":"19","year":"2023","journal-title":"Alzheimers Dement"},{"key":"B6","doi-asserted-by":"publisher","first-page":"653340","DOI":"10.3389\/fnagi.2021.653340","article-title":"Comparative effectiveness of interventions for global cognition in patients with mild cognitive impairment: a systematic review and network meta-analysis of randomized controlled trials.","volume":"13","author":"Xu","year":"2021","journal-title":"Front Aging Neurosci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1177\/08982643251318766","article-title":"Factors associated with physical activity in Alzheimer\u2019s disease: a cross-sectional study of individuals and their caregivers.","volume":"38","author":"Clina","year":"2026","journal-title":"J Aging Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1002\/gps.1830","article-title":"Cognitive impairment in older people: future demand for long-term care services and the associated costs.","volume":"22","author":"Comas-Herrera","year":"2007","journal-title":"Int J Geriatr Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","first-page":"197326","DOI":"10.1155\/2013\/197326","article-title":"Physical exercise and brain functions in older adults.","volume":"2013","author":"Bherer","year":"2013","journal-title":"J Aging Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1039752","DOI":"10.3389\/fpsyt.2022.1039752","article-title":"Non-pharmacological interventions for behavioral and psychological symptoms of dementia: a systematic review and network meta-analysis protocol.","volume":"13","author":"Li","year":"2022","journal-title":"Front Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1177\/08982643251319089","article-title":"Health behaviors and executive function in late adulthood: a time-varying effect modeling analysis.","volume":"38","author":"Jung","year":"2026","journal-title":"J Aging Health"},{"key":"B12","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s12877-025-05702-5","article-title":"Understanding regular exercise behavior in frail older adults: a structural equation model based on social-cognitive variables.","volume":"25","author":"Yu","year":"2025","journal-title":"BMC Geriatr"},{"key":"B13","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12877-018-0900-6","article-title":"Exercise patterns in older adults instructed to follow moderate- or high-intensity exercise protocol - 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