Dose-response relations and the moderators between different types of exercise with cognitive functions in older people with mild cognitive impairment: A secondary analysis of a randomized clinical trial.
Huang X, Zhang S, et al. • Journal of Alzheimer's disease : JAD • 2026
Positive dose-response relations may exist among older adults with MCI, particularly between resistance exercise dose and processing speed, with age, sex, BMI, and baseline physical activity level serving as potential moderators of the exercise dose-cognitive response relationship.
Key Findings
Results
Both aerobic exercise and resistance exercise programs produced positive cognitive changes in older adults with mild cognitive impairment.
Participants were randomized to aerobic exercise (AE) group, resistance exercise (RE) group, or control group, with 36 in each group
28 participants in the AE group and 30 in the RE group were included in dose-response analyses
Remotely supervised six-month training programs were conducted separately for AE and RE
Paired t-tests demonstrated positive cognitive changes following both AE and RE programs
Cognitive functions were evaluated at pre- and post-intervention
Results
A significant dose-response relationship was found between resistance exercise dose and processing speed.
Linear regression revealed a significant dose-response relationship between RE and processing speed (estimate = 5.32, 95% CI (2.07, 8.56), p = 0.003)
This was identified as the most robust dose-response finding in the study
The relationship was identified through linear regression analyses
No equivalently significant dose-response relationship was reported for aerobic exercise and specific cognitive domains
Results
Age, BMI, and baseline physical activity levels were significant moderators of the relationship between aerobic exercise dose and cognitive responses.
Three moderators were identified for the AE dose-cognitive response relationship: age, body mass index (BMI), and physical activity levels at baseline
These moderators were identified through moderation analyses within the secondary analysis framework
The study used a randomized clinical trial design (registration number ChiCTR2100045582)
These findings suggest that individual characteristics influence how older adults with MCI respond to aerobic exercise dose
Results
Age, sex, and BMI appeared to moderate the resistance exercise dose-response relationship, though these findings were less robust.
Three potential moderators were identified for the RE dose-response relationship: age, sex, and BMI
The authors characterized these RE moderation findings as 'less robust' compared to the AE moderation findings
Sex was a moderator for RE but not for AE dose-response relationships
Baseline physical activity level was a moderator for AE but not identified as a moderator for RE
Methods
This study was designed as a secondary analysis of a randomized clinical trial examining remotely supervised exercise in older adults with MCI.
Trial registration number: ChiCTR2100045582
The intervention duration was six months for both exercise types
Exercise was remotely supervised
The original trial had 36 participants per group (AE, RE, and control)
The secondary analysis focused specifically on dose-response relations and moderators
What This Means
This research suggests that both aerobic exercise (like walking or cycling) and resistance exercise (like weight training) can improve thinking and memory abilities in older adults who have mild cognitive impairment (MCI), a condition that sometimes precedes dementia. The study followed participants through a six-month remotely supervised exercise program and found that the amount of resistance exercise a person did was specifically linked to improvements in how quickly they could process information — meaning more exercise was associated with better results in this area.
The study also found that certain personal characteristics influence how much cognitive benefit someone gets from exercise. For aerobic exercise, a person's age, body weight (measured by BMI), and how physically active they were before starting the program all affected how well they responded. For resistance exercise, age, sex, and body weight appeared to play a role, though these findings were less certain. This means that the same exercise program may produce different cognitive benefits depending on who is doing it.
This research suggests that exercise programs for older adults with MCI may need to be tailored to the individual rather than using a one-size-fits-all approach. Factors like a person's age, weight, sex, and starting fitness level could all be relevant in designing the most effective exercise plan to protect cognitive health. The authors note these findings are preliminary and provide a foundation for developing more personalized exercise prescriptions to maximize brain health benefits.
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Huang X, Zhang S, Zhao X, Lan Y, An R, Li B, et al.. (2026). Dose-response relations and the moderators between different types of exercise with cognitive functions in older people with mild cognitive impairment: A secondary analysis of a randomized clinical trial.. Journal of Alzheimer's disease : JAD. https://doi.org/10.1177/13872877261441823