What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cognitive impairment (n=209). Intervention: Physical exercise vs. Low physical exercise. Primary outcome: Direct association between physical exercise and cognitive function (B 0.037, 95% CI 0.005, 0.063, p=0.020).

What does this research mean for the field?

Higher volumes of physical exercise in older adults with cognitive impairment are associated with better cognitive function, an effect that is partially mediated by improved inhibitory control and lower resting-state frontal theta (FP1 + FP2) EEG power. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 20, 2026Frontiers in Public Health0 citationsOpen Access

The correlation between physical exercise and cognitive function in older adults with cognitive impairment mediated by inhibitory control and possible cognitive processing mechanisms

BXBingbin Xie FWFuhai Wang SXSimin Xu

Key Result

Physical exercise was directly associated with cognitive function (B 0.037) and indirectly mediated by inhibitory control and resting-state θ(FP1 + FP2) power in older adults with cognitive impairment.

Study Design

Type

Cross-Sectional (n=209)

Multicenter

Yes

Structured PICO

Does physical exercise correlate with improved cognitive function in older adults with cognitive impairment?

Population

209 older adults with cognitive impairment

Intervention

Physical exercise (assessed using Physical Activity Rating Scale-3)

Outcome

Cognitive function (assessed using Montreal Cognitive Assessment), inhibitory control (Stroop task), and resting-state EEG signalssurrogate

Higher volumes of physical exercise in older adults with cognitive impairment are associated with better cognitive performance, partially mediated by inhibitory control and resting-state EEG θ power.

Main Result

Effect estimate: B 0.037 (95% CI 0.005, 0.063)

p-value: p=0.020

Limitations

Sample was not clinically diagnosed and drawn from only four senior care centers in Shanghai, introducing geographic and institutional selection biases.
Physical exercise volume was assessed via subjective self-reports, which are susceptible to recall biases.
Cross-sectional design inherently precludes causal inferences.
Use of a 16-channel EEG system limited spatial resolution.
Depressive symptomatology was not systematically evaluated.
Fixed block order of the Stroop task may have introduced practice or fatigue effects.
SEM showed an elevated RMSEA, indicating suboptimal absolute model fit.

Abstract

Purpose Cognitive impairment is currently a prominent age-related challenge among older adults. This study examined the relationships between inhibitory control, cognitive function, EEG indicators, and physical exercise in older adults with cognitive impairment, and explored the mediating roles of EEG indicators and inhibitory control in the association between physical exercise and cognitive function. Patients and methods A total of 239 older adults were recruited, of whom 209 were included in the final analysis. Cognitive function and physical exercise were assessed using the Montreal Cognitive Assessment (MoCA) and Physical Activity Rating Scale-3 (PARS-3), respectively. Inhibitory control was evaluated using the Stroop task and 5 min of resting-state EEG signals were recorded. Results Cognitive function was significantly associated with inhibitory control in older adults with cognitive impairment. θ (FP1 + FP2) power emerged as a specific EEG indicator correlated with both cognitive function and inhibitory control. A significant negative correlation was observed between physical exercise volume and resting-state θ (FP1 + FP2) power ( r = −0.288, p 0.05). Mediation analysis revealed a significant direct association between physical exercise and cognitive function ( B = 0.037, 95%CI: 0.005, 0.063, p = 0.020). Furthermore, physical exercise was indirectly associated with cognitive function through three significant pathways: the independent mediation of θ (FP1 + FP2) power ( B = 0.008, p = 0.022), the independent mediation of inhibitory control ( B = 0.013, p = 0.011), and a chain mediation from θ (FP1 + FP2) power to inhibitory control ( B = 0.003, 95%CI: 0.001, 0.009, p = 0.028). Collectively, these indirect pathways accounted for 39.0% of the total association. Conclusion Higher volumes of physical exercise in older adults are associated with superior inhibitory control and cognitive performance, as well as lower resting-state θ (FP1 + FP2) power. θ (FP1 + FP2) serves as a shared neuroelectrophysiological marker linked to both inhibitory control and cognitive function. Furthermore, exploratory SEM suggested that this EEG-specific indicator and inhibitory control may statistically mediate the association between physical exercise and cognitive function.

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