{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:59:58Z","timestamp":1790315998418,"version":"4.1.0"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"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. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alzheimer\u2019s disease (AD), Parkinson\u2019s disease (PD), and mild cognitive impairment (MCI) are commonly accompanied by cognitive decline. Although exercise is recommended as a non-pharmacological strategy, the comparative effects of different exercise modalities on global cognition remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare six exercise modalities\u2014aerobic exercise (AE), mind\u2013body exercise (MBE), resistance training (RT), multi-component exercise (MCE), flexibility training (FT), and functional training (FTr)\u2014for global cognitive function in people with AD, PD, or MCI, and to explore dose-related associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to January 26, 2026. Randomized controlled trials (RCTs) were synthesized using a frequentist random-effects network meta-analysis (NMA) with standardized mean differences (SMDs) and 95% confidence intervals (CIs). Treatment rankings were summarized using SUCRA. Subgroup analyses, meta-regression, diagnosis-related sensitivity analyses, and CINeMA certainty assessments were also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-eight trials involving 1,993 participants were included. Compared with control group (CG), AE [SMD\u202f=\u202f0.47, 95% CI (0.18, 0.77)], MBE [SMD\u202f=\u202f0.79, 95% CI (0.46, 1.11)], RT [SMD\u202f=\u202f1.50, 95% CI (0.77, 2.23)], MCE [SMD\u202f=\u202f0.83, 95% CI (0.26, 1.40)], and FTr [SMD\u202f=\u202f0.83, 95% CI (0.13, 1.53)] improved global cognition, whereas FT showed no clear effect [SMD\u202f=\u202f-0.20, 95% CI (\u22121.27,0.87)]. RT ranked first, followed by MCE, FTr, MBE, AE, and FT. Heterogeneity was substantial (\u03c4\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f0.23; I\n                      <jats:sup>2<\/jats:sup>\n                      =\u202f80%), although no statistically significant global incoherence was detected. RT remained first after the exclusion of AD, PD, or MCI studies. Studies lasting more than 12\u202fweeks, delivered 3\u20135 times per week, and using sessions of 31\u201360\u202fmin showed favorable pooled effects, but subgroup interaction tests and meta-regression were not significant. Certainty of evidence ranged from low to very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AE, MBE, RT, MCE, and FTr may improve global cognition in people with AD, PD, or MCI. RT showed the largest effect estimate and the most favorable ranking. However, substantial heterogeneity and sparse evidence for several modalities limit firm conclusions. Exercise selection should be individualized, and dose-related findings require confirmation in adequately powered comparative trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1877537","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:32:54Z","timestamp":1790314374000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative effects of six exercise modalities on global cognitive function in Alzheimer\u2019s disease, Parkinson\u2019s disease, and mild cognitive impairment: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaolin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Physical Education and Training, School of Physical Education, Hebei Normal University","place":["Shijiazhuang, Hebei, 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of Physical Education and Training, School of Physical Education, Hebei Normal University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Training, School of Physical Education, Hebei Normal University","place":["Shijiazhuang, Hebei, China"]},{"name":"Department of Chinese Traditional Physical Education, School of Physical Education, Hebei Normal University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1038\/s41582-019-0244-7","article-title":"Ageing as a risk factor for neurodegenerative disease","volume":"15","author":"Hou","year":"2019","journal-title":"Nat Rev 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