Impact of exercise intervention on depression, anxiety, sleep and quality of life in patients with cognitive impairment: a systematic review and network Meta-analysis

Guangyao Sun¹Xingyi Ding¹Hongtao Ma¹Zhong Zheng^2*

• ¹Beijing Sport University, Beijing, China
• ²Peking University, Beijing, China

Background Exercise, as a non-pharmacological intervention, demonstrates considerable potential for improving depression, anxiety, sleep, and quality of life (QoL) in patients with cognitive impairment. However, the optimal exercise modality remains unclear. This study aimed to evaluate and rank the efficacy of exercise types on these outcomes in patients with cognitive impairment. Methods A systematic search of PubMed, Web of Science, Embase, and Cochrane Library was conducted to identify studies published between September 2014 and September 2024. Included studies were randomized controlled trials assessing the impact of exercise on depression, anxiety, sleep, and QoL in cognitively impaired individuals. Depression served as the primary outcome, with anxiety, sleep, and QoL as secondary outcomes. All statistical analyses, including pairwise and network meta-analyses, were performed using R version 4.4.1. Results Forty studies involving 2,937 participants were included. Exergaming demonstrated superior effectiveness in reducing depression (SMD = −12.52, 95% CrI: −20.6 to −4.53) and anxiety (SMD = −12.49, 95% CrI: −31.27 to 5.98). Multicomponent exercise (ME) significantly reduced depression (SMD = −8.01, 95% CrI: −11.15 to −3.59), while mind-body exercise (MBE) improved quality of life (SMD = 12.61, 95% CrI: 0.73 to 32.77). Conclusion Exergaming proved most effective for reducing depression and anxiety in individuals with cognitive impairment. Multicomponent exercise showed substantial benefits for mood regulation, while mind-body exercise was particularly effective for enhancing QoL.