Comparative Effects of Traditional Chinese Mind – Body Exercises on Cognitive Function in Middle-Aged and Older Adults: A Systematic Review and Network Meta-Analysis.

BACKGROUND: Age-related cognitive decline is highly prevalent, highlighting need for scalable exercise interventions. Traditional Chinese mind-body exercises (TCMBEs) may benefit cognition, but their comparative efficacy and optimal regimen remain uncertain. This study compared six TCMBEs and explored dose-response signals. METHODS: A systematic review and network meta-analysis of randomized controlled trials was conducted following PRISMA guidelines. Databases were searched to July 10, 2025. Global cognition measured by MMSE or MoCA was primary outcome. Bayesian random-effects models estimated standardized mean differences (SMDs), and interventions were ranked using SUCRA. Sensitivity analyses applied frequentist models. The protocol was registered (CRD42025633650). RESULTS: Thirty-three trials involving 2503 participants were included. Compared with passive control, Baduanjin (SMD = 0.37; 95% CI 0.14-0.61), Qigong (SMD = 0.33; 95% CI 0.04-0.61), and Tai Chi (SMD = 0.30; 95% CI 0.14-0.45) significantly improved cognition. SUCRA ranked Baduanjin highest, followed by Qigong and Tai Chi. Overall heterogeneity was moderate (I2 ≈46%). Higher weekly frequency combined with shorter session duration showed greater benefits, although differences were not statistically significant (p = .381). CONCLUSIONS: TCMBEs improve cognitive function in adults aged 50 years and older, with Baduanjin, Qigong, and Tai Chi showing the greatest potential. High-frequency, shorter-duration practice appears feasible, but findings should guide rather than dictate exercise prescriptions.