Multicomponent strength training, cognition and muscle quality in older adults. Systematic review and narrative synthesis
DOI:
https://doi.org/10.47197/retos.v79.118659Keywords:
Cognitive functions, elderly, physical fitness, muscle strength, systematic reviewAbstract
Introduction: Population aging is associated with progressive declines in both muscular and cognitive function. Multicomponent exercise programs are widely recommended; however, the specific contribution of muscle quality, beyond mere muscle mass, to cognitive outcomes remains a critical gap in current evidence.
Objective: The aim was to systematically review and synthesize the effects of multicomponent resistance-based exercise interventions on cognition and indicators of muscle quality in older adults, highlighting the role of the muscle-brain axis as a central explanatory factor.
Methodology: A systematic search was conducted in PubMed, Web of Science, Scopus, and CINAHL Complete. Clinical trials evaluating chronic multicomponent exercise interventions with resistance training as a central component were included. Outcomes involved executive functions, while muscular emphasized strength, power, and functional performance as indicators of muscle quality. Risk of bias was assessed using the RoB-2 tool.
Results: Eight randomized controlled trials were included. Most studies reported improvements in executive functions, particularly inhibitory control and cognitive flexibility, alongside concurrent gains in muscular strength and power. Associations with cognitive outcomes were more consistent for muscle quality indicators than for muscle mass.
Discussion: Findings suggest that neuromuscular demands play a relevant role in mediating cognitive benefits. This highlights that functional adaptations may be more determinant for cognitive health than quantitative changes in muscle volume.
Conclusions: Multicomponent resistance-based exercise supports executive functioning, with muscle quality emerging as a key factor for designing more precise clinical interventions.
References
Baltasar-Fernandez, I., Alcazar, J., Gómez-Cabello, A., Moradell, A., Chamizo, R. P., Alegre, L. M., Villa-Vicente, J. G., Gusi, N., González-Gross, M., Casajús, J. A., Vicente-Rodríguez, G., & Ara, I. (2025). Changes and major determinants of relative muscle power loss in older adults: results from an 8-year longitudinal study. European Journal Of Applied Physio-logy. https://doi.org/10.1007/s00421-025-05947-3
Buckinx, F., & Aubertin-Leheudre, M. (2019). Relevance to assess and preserve muscle strength in aging field. Progress In Neuro-Psychopharmacology And Biological Psychiatry, 94, 109663. https://doi.org/10.1016/j.pnpbp.2019.109663
Butler, A., Hall, H., & Copnell, B. (2016). A Guide to Writing a Qualitative Systematic Review Protocol to Enhance Evidence‐Based Practice in Nursing and Health Care. Worldviews On Evidence-Based Nursing, 13(3), 241-249. https://doi.org/10.1111/wvn.12134
Campbell, M., McKenzie, J. E., Sowden, A., Katikireddi, S. V., Brennan, S. E., Ellis, S., Hartmann-Boyce, J., Ryan, R., Shepperd, S., Thomas, J., Welch, V., & Thomson, H. (2020). Synthesis without meta-analysis (SWiM) in systematic reviews: reporting guideline. BMJ, 368, l6890. https://doi.org/10.1136/bmj.l6890
Clark, B. (2019). Neuromuscular Changes with Aging and Sarcopenia. The Journal Of Frailty & Ag-ing, 8(1), 7-9. https://doi.org/10.14283/jfa.2018.35
De Bruin, E., Eggenberger, P., Schumacher, V., Angst, M., & Theill, N. (2015). Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up. Clinical Interven-tions In Aging, 10, 1335. https://doi.org/10.2147/cia.s87732
De Oliveira Silva, F., Ferreira, J. V., Plácido, J., Sant’Anna, P., Araújo, J., Marinho, V., Laks, J., & Deslandes, A. C. (2019). Three months of multimodal training contributes to mobility and executive func-tion in elderly individuals with mild cognitive impairment, but not in those with Alzheimer’s disease: A randomized controlled trial. Maturitas, 126, 28-33. https://doi.org/10.1016/j.maturitas.2019.04.217
Feter, N., Schaun, G. Z., Smith, E. C., Cassuriaga, J., Alt, R., Redig, L., Alberton, C. L., Coombes, J. S., & Rom-baldi, A. J. (2023). High-velocity resistance training improves executive function in mobility-limited older adults. Archives Of Gerontology And Geriatrics, 114, 105081. https://doi.org/10.1016/j.archger.2023.105081
Forsyth, F., Soh, C. L., Elks, N., Lin, H., Bailey, K., Rowbotham, S., Mant, J., Hartley, P., & Deaton, C. (2024). Exercise Modalities in Multi-Component Interventions for Older adults with Multi-Morbidity: A Systematic Review and Narrative Synthesis. The Journal Of Frailty & Aging, 13(4), 341-348. https://doi.org/10.14283/jfa.2024.28
García-García, J., Benavides-Rodríguez, L., & Fernandez-Ortega, J. (2025). Efectos del entrenamiento de fuerza sobre la condición física funcional en el adulto mayor. Retos, 76, 68-77. https://doi.org/10.47197/retos.v76.100103
Ge, J., Wang, Q., Wang, S., Xiong, X., & Zhai, Y. (2025). Optimal dose and type of exercise to improve cog-nitive function in adults with major depressive disorder: a systematic review and Bayesian model-based network meta-analysis. Frontiers In Public Health, 13. https://doi.org/10.3389/fpubh.2025.1662778
Goh, J. O., An, Y., & Resnick, S. M. (2011). Differential trajectories of age-related changes in components of executive and memory processes. Psychology And Aging, 27(3), 707-719. https://doi.org/10.1037/a0026715
Herold, F., Törpel, A., Schega, L., & Müller, N. G. (2019). Functional and/or structural brain changes in response to resistance exercises and resistance training lead to cognitive improvements – a sys-tematic review. European Review Of Aging And Physical Activity, 16(1), 10. https://doi.org/10.1186/s11556-019-0217-2
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., & Sterne, J. A. C. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 343(oct18 2), d5928. https://doi.org/10.1136/bmj.d5928
James, E., Nichols, S., Goodall, S., Hicks, K. M., & O’Doherty, A. F. (2021). The influence of resistance training on neuromuscular function in middle-aged and older adults: A systematic review and meta-analysis of randomised controlled trials. Experimental Gerontology, 149, 111320. https://doi.org/10.1016/j.exger.2021.111320
Jerez Salas, F., Villouta-Gutiérrez, O., Pavez-Álvarez, C., & Luksic-Cataldo, V. (2026). Efectos de los exer-games no inmersivos en funciones ejecutivas de adultos mayores sanos. Una revisión sistemáti-ca y metaanálisis. Retos, 76, 330-345. https://doi.org/10.47197/retos.v76.117767
Jurakic, Z. G., Krizanic, V., Sarabon, N., & Markovic, G. (2017). Effects of feedback-based balance and core resistance training vs. Pilates training on cognitive functions in older women with mild cognitive impairment: a pilot randomized controlled trial. Aging Clinical And Experimental Re-search, 29(6), 1295-1298. https://doi.org/10.1007/s40520-017-0740-9
Kendall, H., Kipp, L. E., & Mettler, J. A. (2025). Resistance Training Preserves Physical Function in Older Community-Dwelling Adults. Translational Journal Of The American College Of Sports Medi-cine, 10(3). https://doi.org/10.1249/tjx.0000000000000312
Kolaski, K., Logan, L. R., & Ioannidis, J. P. A. (2023). Guidance to best tools and practices for systematic reviews. British Journal Of Pharmacology, 181(1), 180-210. https://doi.org/10.1111/bph.16100
Kroemer, G. (2025). Exercise attenuates the hallmarks of aging: Novel perspectives. Journal Of Sport And Health Science/Journal Of Sport And Health Science, 101108. https://doi.org/10.1016/j.jshs.2025.101108
Kušleikienė, S., Ziv, G., Vints, W. A. J., Krasinskė, E., Šarkinaite, M., Qipo, O., Bautmans, I., Himmelreich, U., Masiulis, N., Česnaitienė, V. J., & Levin, O. (2025). Cognitive gains and cortical thickness changes after 12 weeks of resistance training in older adults with low and high risk of mild cognitive impairment: Findings from a randomized controlled trial. Brain Research Bulletin, 222, 111249. https://doi.org/10.1016/j.brainresbull.2025.111249
Lacio, M., Vieira, J. G., Trybulski, R., Campos, Y., Santana, D., Filho, J. E., Novaes, J., Vianna, J., & Wilk, M. (2021). Effects of Resistance Training Performed with Different Loads in Untrained and Trained Male Adult Individuals on Maximal Strength and Muscle Hypertrophy: A Systematic Review. International Journal Of Environmental Research And Public Health, 18(21), 11237. https://doi.org/10.3390/ijerph182111237
Lecce, E., Amoruso, P., Del Vecchio, A., Casolo, A., Felici, F., Farina, D., & Bazzucchi, I. (2025). Neural determinants of the increase in muscle strength and force steadiness of the untrained limb fol-lowing a 4 week unilateral training. The Journal Of Physiology, 603(12), 3605-3630. https://doi.org/10.1113/jp288954
Li, Y., Gao, Y., Hu, S., Chen, H., Zhang, M., Yang, Y., & Liu, Y. (2022). Effects of multicomponent exercise on the muscle strength, muscle endurance and balance of frail older adults: A meta‐analysis of randomised controlled trials. Journal Of Clinical Nursing, 32(9-10), 1795-1805. https://doi.org/10.1111/jocn.16196
Logan, N. E., & Lim, M. (2025). Efficacy of exercise interventions for executive function in children with ADHD: What is the current verdict? Pediatric Research. https://doi.org/10.1038/s41390-025-04646-1
Martins, V. F., Peyré-Tartaruga, L. A., Haas, A. N., Kanitz, A. C., Martinez, F. G., & Gonçalves, A. K. (2024). Observational evidence of the association between physical and psychological determinants of aging with cognition in older adults. Scientific Reports, 14(1), 12574. https://doi.org/10.1038/s41598-024-58497-7
McNeish, B. L., Miljkovic, I., Liu-Ambrose, T., Ambrosio, F., Esser, K., Fahnestock, M., & Rosano, C. (2025). Muscle-brain crosstalk as a driver of brain health in aging. GeroScience. https://doi.org/10.1007/s11357-025-01833-0
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1. https://doi.org/10.1186/2046-4053-4-1
Montero-Odasso, M., Zou, G., Speechley, M., Almeida, Q. J., Liu-Ambrose, T., Middleton, L. E., Camicioli, R., Bray, N. W., Li, K. Z. H., Fraser, S., Pieruccini-Faria, F., Berryman, N., Lussier, M., Shoemaker, J. K., Son, S., Bherer, L., McFadyen, B. J., Barha, C., & McGibbon, C. (2023). Effects of Exercise Alone or Combined With Cognitive Training and Vitamin D Supplementation to Improve Cognition in Adults With Mild Cognitive Impairment. JAMA Network Open, 6(7), e2324465. https://doi.org/10.1001/jamanetworkopen.2023.24465
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetz-laff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., . . . Alonso-Fernández, S. (2021c). De-claración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Re-vista Española de Cardiología, 74(9), 790-799. https://doi.org/10.1016/j.recesp.2021.06.016
Perice, L., Barzilai, N., Verghese, J., Weiss, E. F., Holtzer, R., Cohen, P., & Milman, S. (2016). Lower circu-lating insulin-like growth factor-I is associated with better cognition in females with exception-al longevity without compromise to muscle mass and function. Aging, 8(10), 2414-2424. https://doi.org/10.18632/aging.101063
Prommaban, A., Moonkayaow, S., Phinyo, P., Siviroj, P., Sirikul, W., & Lerttrakarnnon, P. (2024). The Effect of Exercise Program Interventions on Frailty, Clinical Outcomes, and Biomarkers in Old-er Adults: A Systematic Review. Journal Of Clinical Medicine, 13(21), 6570. https://doi.org/10.3390/jcm13216570
Rai, H. K., Barroso, A. C., Yates, L., Schneider, J., & Orrell, M. (2020). Involvement of People With Demen-tia in the Development of Technology-Based Interventions: Narrative Synthesis Review and Best Practice Guidelines. Journal Of Medical Internet Research, 22(12), e17531. https://doi.org/10.2196/17531
Roldán, M. J. J., & Olmedo, M. C. (2025). Efecto del entrenamiento de fuerza de baja y alta velocidad in-tencional sobre las funciones ejecutivas en niños: un ensayo controlado aleatorizado. Retos, 68, 201-211. https://doi.org/10.47197/retos.v68.113321
Romare, M., Elcadi, G. H., Johansson, E., & Tsaklis, P. (2023). Relative Neuroadaptive Effect of Re-sistance Training along the Descending Neuroaxis in Older Adults. Brain Sciences, 13(4), 679. https://doi.org/10.3390/brainsci13040679
Sánchez-Sánchez, J. L., De Souto Barreto, P., Antón-Rodrigo, I., Ramón-Espinoza, F., Marín-Epelde, I., Sánchez-Latorre, M., Moral-Cuesta, D., & Casas-Herrero, Á. (2022). Effects of a 12-week Vivifrail exercise program on intrinsic capacity among frail cognitively impaired community-dwelling older adults: secondary analysis of a multicentre randomised clinical trial. Age And Age-ing, 51(12). https://doi.org/10.1093/ageing/afac303
Siddique, U., Frazer, A. K., Avela, J., Walker, S., Ahtiainen, J. P., Howatson, G., Tallent, J., & Kidgell, D. J. (2022). Determining the cortical, spinal and muscular adaptations to strength-training in older adults: A systematic review and meta-analysis. Ageing Research Reviews, 82, 101746. https://doi.org/10.1016/j.arr.2022.101746
Smolarek, A., Ferreira, L. H., Mascarenhas, L. P., McAnulty, S. R., Varela, K., Dangui, M., Barros, M. P., Ut-ter, A. C., & Souza-Junior, T. (2016). The effects of strength training on cognitive performance in elderly women. Clinical Interventions In Aging, 11, 749. https://doi.org/10.2147/cia.s102126
Sterne, J. A., Hernán, M. A., Reeves, B. C., Savović, J., Berkman, N. D., Viswanathan, M., Henry, D., Altman, D. G., Ansari, M. T., Boutron, I., Carpenter, J. R., Chan, A., Churchill, R., Deeks, J. J., Hróbjartsson, A., Kirkham, J., Jüni, P., Loke, Y. K., Pigott, T. D., . . . Higgins, J. P. (2016). ROBINS-I: a tool for as-sessing risk of bias in non-randomised studies of interventions. BMJ, 355, i4919. https://doi.org/10.1136/bmj.i4919
Sui, S. X., Williams, L. J., Holloway-Kew, K. L., Hyde, N. K., & Pasco, J. A. (2020). Skeletal Muscle Health and Cognitive Function: A Narrative Review. International Journal Of Molecular Scienc-es, 22(1), 255. https://doi.org/10.3390/ijms22010255
Suzuki, T., Shimada, H., Makizako, H., Doi, T., Yoshida, D., Tsutsumimoto, K., Anan, Y., Uemura, K., Lee, S., & Park, H. (2012). Effects of multicomponent exercise on cognitive function in older adults with amnestic mild cognitive impairment: a randomized controlled trial. BMC Neurolo-gy, 12(1), 128. https://doi.org/10.1186/1471-2377-12-128
Tarazona-Santabalbina, F. J., Gómez-Cabrera, M. C., Pérez-Ros, P., Martínez-Arnau, F. M., Cabo, H., Tsaparas, K., Salvador-Pascual, A., Rodriguez-Mañas, L., & Viña, J. (2016). A Multicomponent Ex-ercise Intervention that Reverses Frailty and Improves Cognition, Emotion, and Social Net-working in the Community-Dwelling Frail Elderly: A Randomized Clinical Trial. Journal Of The American Medical Directors Association, 17(5), 426-433. https://doi.org/10.1016/j.jamda.2016.01.019
Travaglini, S., Bonvicini, M., Bandinelli, S., Ferrucci, L., Incalzi, R. A., & Pedone, C. (2025). Has Muscle Power Better Discriminative Capacity Compared to Muscle Strength in Predicting Worsening Disability in Older Adults? The Journals Of Gerontology Series A, 80(3). https://doi.org/10.1093/gerona/glaf003
Uchida, K., Sugimoto, T., Tange, C., Nishita, Y., Shimokata, H., Saji, N., Kuroda, Y., Matsumoto, N., Kishino, Y., Ono, R., Akisue, T., Otsuka, R., & Sakurai, T. (2023). Association between Reduction of Muscle Mass and Faster Declines in Global Cognition among Older People: A 4-Year Prospective Cohort Study. The Journal Of Nutrition Health & Aging, 27(11), 932-939. https://doi.org/10.1007/s12603-023-2007-9
Virto, N., Río, X., Méndez-Zorrilla, A., & García-Zapirain, B. (2024). Non invasive techniques for direct muscle quality assessment after exercise intervention in older adults: a systematic review. BMC Geriatrics, 24(1), 642. https://doi.org/10.1186/s12877-024-05243-3
Wang, R., & Holsinger, R. M. D. (2018). Exercise-induced brain-derived neurotrophic factor expression: Therapeutic implications for Alzheimer’s dementia. Ageing Research Reviews, 48, 109-121. https://doi.org/10.1016/j.arr.2018.10.002
Wollesen, B., & Voelker-Rehage, C. (2025). Chronic exercise and executive functions in older adults – the treasury of combined cognitive and motor exercise. Psychology Of Sport And Exercise, 82, 103023. https://doi.org/10.1016/j.psychsport.2025.103023
Wu, J., & Huang, C. (2025). A systematic review and meta-analysis of the effects of resistance exercise on cognitive function in older adults. Frontiers In Psychiatry, 16. https://doi.org/10.3389/fpsyt.2025.1708244
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Felipe Jerez-Salas, Orlando Villouta-Gutiérrez, Valentina Luksic-Cataldo, Cristal Pavez-Álvarez
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
- Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).
This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.
