Effects of physical exercise interventions on cognitive function in Parkinson’s disease: an updated systematic review and meta-analysis of randomized controlled trials

It remains unclear whether and how physical exercise affects cognitive function in patients with Parkinson’s disease (PD). Here, we aimed to determine whether physical exercise interventions can improve cognitive function, including overall performance and specific domains, in these patients and to provide potential evidence on how cognitive benefits can be optimized by exercise prescriptions. This systematic review and meta-analysis included 761 patients from 21 randomized controlled trials. Physical exercise interventions showed positive effects on global cognitive function (standardized mean difference [SMD] = 0.69; 95% confidence interval [CI] = 0.31 to 1.06; P  < 0.001) and, to a lesser extent, executive function (SMD = 0.94; 95% CI = 0.05 to 1.83; P  = 0.039). Combined exercise type, exercise interventions of light-to-moderate intensity with at least 60 min in duration, and of any frequency or period, were beneficial to the global cognitive function. These findings suggest clear cognitive benefits of physical exercise in patients with PD. At least 60 min a day of combined exercise programs on as many days of the week as feasible may be recommended as the non-pharmacological therapeutic option to improve cognitive function.