The efficacy versus evidence quality of multicompomnent exercise for cognitive health in older adults: an umbrella review.

Introduction: Multicomponent exercise (MCE) is a promising strategy for enhancing cognitive function in older adults. This umbrella review aimed to synthesize and critically appraise the evidence from systematic reviews and meta-analyses on the effects of multicomponent physical exercise on cognition in this population. Methods: An umbrella review of systematic reviews with or without meta-analysis was conducted. Six electronic databases (PubMed, Web of Science, Embase, Scopus, SPORTDiscus, and the Cochrane Library) were searched from their inception to September 2025 to identify eligible studies. The methodological quality of the included reviews was assessed using the AMSTAR-2 tool, and the overall certainty of the evidence for key outcomes was evaluated using the GRADE framework. Results: The synthesis included 27 systematic reviews. MCE demonstrated consistently statistically significant, moderate positive effects on global cognitive function (SMD = 0.45) and executive function (SMD = 0.31). regarding memory, while the overall effect and verbal memory showed significant improvements, specific sub-domains such as working memory and delayed memory did not reach statistical significance. Similarly, no significant effect was observed for attention/processing speed. Despite these positive findings, the methodological quality of the majority of the included reviews (22 of 27) was rated as "Low" or "Critically Low" by AMSTAR-2. Consequently, the certainty of the evidence according to GRADE was predominantly "Low" to "Very Low" for most cognitive outcomes, with "Moderate" certainty achieved only for global cognitive function. Conclusion: Multicomponent exercise is an effective intervention for improving global cognitive function and executive function in older adults. While benefits for specific memory domains and processing speed were less consistent, these findings support the clinical and public health promotion of MCE, while simultaneously highlighting an urgent need for more methodologically rigorous research to solidify the evidence base. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/ CRD420251161230, identifier CRD420251161230.