From movement to mood regulation: exercise-based digital interventions using mobile health and ecological momentary assessment for mental health and cognitive function in older adults: a narrative review.

This narrative review aims to synthesize current evidence on the integration of exercise with mobile health technologies and ecological momentary assessment or intervention (EMA/EMI) to promote mental and cognitive well-being in older adults. Given the rapid aging of the global population and the high attrition rates in traditional exercise programs, evaluating these digital, real-time modalities is of significant scientific interest. To capture the current evidence base, a comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. Peer-reviewed articles encompassing randomized controlled trials, pilot studies, and observational designs that evaluated digitally supported exercise interventions for mental and cognitive health in adults aged 50 and older were selected for this narrative synthesis. Recent empirical investigations have demonstrated the increasing application of digital modalities, including wearable activity monitors, smartphone applications, and sensor-initiated evaluations, within exercise regimens to facilitate the real-time tracking and adjustment of physical activity levels. The potential benefits of these technological interventions on mental and cognitive outcomes may operate via dynamic behavioral and neurophysiological feedback processes. The evidence generally suggests that elevated levels of physical activity correlate positively with enhanced mood, reductions in depressive symptoms, and improved cognitive functioning, whereas sedentary behaviors and fatigue are associated with detrimental affective outcomes. Significantly, studies employing EMA elucidate considerable intra-individual variability, indicating that alterations in motivation, self-efficacy, stress, fatigue, and social context may influence behavioral engagement and emotional reactivity over time. Ecological momentary interventions and just-in-time adaptive interventions further suggest that customized exercise prompts delivered within real-world environments may support increases in physical activity engagement, reductions in sedentary behavior, and improvements in selected cognitive outcomes, potentially through the context-sensitive reinforcement of self-regulation, neuroplasticity, and adaptive stress-response mechanisms. Collectively, these investigations provide emerging evidence supporting the potential role of exercise-oriented digital interventions as a bio-digital framework for promoting mental and cognitive well-being in aging populations via real-time monitoring and adaptive behavioral assistance.