Evidence map›Paper›PMID 42318267›Full record

SynthesisJournal of sports science & medicine2026

Comparative Efficacy of Different Aquatic Exercise Modalities on Cognitive Function in The Elderly: A Systematic Review and Network Meta-Analysis.

Jinglei Song, Zhili Ma, Bingting Luo, Ting Liao, Yong Tai Wang, Ziren Zhao, Xin Zheng

Abstract readSystematic ReviewNetwork Meta-AnalysisComparative Study
In one paragraph

Synthesis in Journal of sports science & medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jinglei SongAquatic Therapy and Fitness Research Centre, Wuhan Sports University, Wuhan, China.
Zhili MaSchool of Physical Education and Health, Chengdu University of Traditional Chinese Medicine.
Bingting LuoAquatic Therapy and Fitness Research Centre, Wuhan Sports University, Wuhan, China.
Ting LiaoAquatic Therapy and Fitness Research Centre, Wuhan Sports University, Wuhan, China.
Yong Tai WangCollege of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, United States, College of Physical Education and Health Science.
Ziren ZhaoChongqing Normal University, Chongqing, No. 37, Middle Road, University Town, Shapingba District, Chongqing.
Xin ZhengChongqing Normal University, Chongqing, No. 37, Middle Road, University Town, Shapingba District, Chongqing.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cognitive decline poses a major challenge in aging populations, and aquatic exercise may offer cognitive benefits while reduceding injury risk. This systematic review and network meta-analysis (NMA) evaluated the comparative effectiveness of different aquatic exercise modalities on cognitive function in older adults. Major electronic databases were searched from inception to January 2026 for randomized controlled trials (RCTs) examining aquatic exercise and cognitive outcomes in adults aged ≥60 years; studies were independently assessed by two reviewers. Interventions were categorized as aquatic cognitive-motor exercise, aquatic aerobic exercise, aquatic high-intensity interval training (HIIT), and aquatic strength training. A frequentist NMA was used to synthesize direct and indirect evidence, with effect sizes expressed as standardized mean differences (SMDs). Nine RCTs (involving 324 participants) met the inclusion criteria. Aquatic cognitive-motor exercise showed the highest probability of being the most effective intervention (SUCRA [surface under the cumulative ranking curve] = 85.36%), followed by aquatic aerobic exercise (61.44%) and aquatic strength training (51.80%). Aquatic HIIT (49.12%) and land-based exercise (48.34%) demonstrated moderate effects. Among all modalities only aquatic cognitive-motor exercise showed statistically significant improvements compared with non-exercising controls. Based on the currently available limited evidence, aquatic cognitive-motor exercise may be the most effective aquatic modality for improving cognitive function in older adults. All aquatic exercise modalities provided cognitive benefits at least comparable to those of land-based exercise. The findings suggest that cognitive engagement, rather than exercise intensity alone, may be crucial for maximizing the efficacy of the intervention. However, as only nine RCTs were included, these findings should be interpreted with caution given the limited size and density of the evidence network.

Indexed as

CognitionCognitive DysfunctionExerciseAgedCognitive EnhancementHigh-Intensity Interval TrainingHumansRandomized Controlled Trials as TopicResistance Trainingaquatic cognitive-motor exerciseAquatic exercisecognitionolder

Identifiers

PMID42318267
PMCPMC13274440

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.