Effects of exercise interventions on cognitive function in sedentary adults: a systematic review and network meta-analysis.

Objective: This study aims to systematically compare and evaluate the effects of different types of exercise interventions on cognitive function in sedentary adults through a systematic review and network meta-analysis, quantifying their relative effectiveness to provide evidence for formulating precise exercise prescriptions. Methods: Electronic databases including PubMed, Embase, Cochrane Library, Scopus, Web of Science, and EBSCO were systematically searched from their inception until December 30, 2025, for RCTs comparing exercise interventions with a sedentary control on cognitive outcomes in sedentary adults. Literature screening, data extraction, and risk-of-bias assessment were conducted based on predefined PICOS criteria. For global cognition and executive function, which involved multiple exercise types forming connected networks, a frequentist network meta-analysis was performed to integrate direct and indirect evidence. The surface under the cumulative ranking curve was used to rank interventions. For memory function, due to the absence of a connected network, a standard pairwise meta-analysis was conducted using a random-effects model. All effect sizes were calculated as standardized mean differences with 95% confidence intervals. Results: Seventeen RCTs involving 2,187 sedentary adults were included. Interventions were categorized as aerobic exercise, resistance exercise, and multicomponent exercise. The network meta-analysis results indicated that for improving global cognitive function, multicomponent exercise was most effective (SUCRA = 88.5%), followed by aerobic exercise (SUCRA = 58.3%) and resistance exercise (SUCRA = 48.5%). For executive function, aerobic exercise ranked highest (SUCRA = 90.8%), followed by multicomponent exercise (SUCRA = 50.7%) and resistance exercise (SUCRA = 38.1%). For memory function, exercise demonstrated a small-to-moderate improvement compared to control that approached but did not reach statistical significance (SMD = 0.33, 95% CI: -0.02 to 0.68). According to the GRADE framework, direct comparisons were rated as moderate quality, while most indirect and mixed comparisons showed very low certainty, indicating the need for cautious interpretation. Conclusion: Exercise interventions effectively improve cognitive function in sedentary adults, with effects demonstrating domain specificity. Multicomponent exercise appears optimal for enhancing global cognition, while aerobic exercise shows prominent benefits for improving executive function. These findings support targeting exercise prescriptions to specific cognitive goals, although further high-quality research is warranted for confirmation. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251253097, identifier PROSPERO (CRD420251253097).