Optimizing cognitive functions in healthy older adults: a network meta-analysis of dual- and single-task interventions

Physical and cognitive interventions, alone or combined, are recognized strategies to enhance cognitive function in healthy older adults, though their relative effectiveness remains debated. This study aimed to compare and classify the impact of such interventions on cognitive performance. Following PRISMA guidelines, randomized controlled trials (RCTs) were identified through searches of PubMed, Web of Science, and Scopus, with screening and data extraction procedures guided by the Cochrane Handbook for Systematic Reviews of Interventions. The protocol was registered on PROSPERO (CRD42024565879). A network meta-analysis synthesized results from 87 studies including participants aged 65 and older. Interventions were grouped into seven groups, covering dual-task, single-task, technology-based formats, and a control group. Compared with controls, cognitive-motor dual-task training showed the strongest effects (SMD = 0.71, 95% CI 0.45, 0.97). Differences between exercise types were not statistically significant. However, dual-task approaches, whether technology-supported or not, outperformed traditional physical training (e.g., SMD = 0.33, 95% CI 0.05, 0.61). Findings suggest that dual-task interventions effectively enhance cognitive performance, with technology adding value by creating engaging and adaptive experiences. Technology particularly strengthened single-task training. Future research should examine specific executive functions and scalable technology-based methods to guide evidence-based strategies that promote healthy aging and cognitive resilience.