Comparative efficacy of exercise modalities on cardiometabolic health in older adults: A systematic review and network meta-analysis.

In 30 seconds

This systematic review and network meta-analysis compared exercise modalities for cardiometabolic risk factors in adults aged 60 years or older, using randomized controlled trials identified through November 30, 2025. It included 57 trials and 3655 participants. Modalities showed different outcome rankings: traditional Chinese training ranked highest for total cholesterol and low-density lipoprotein, while other modalities ranked highest for different lipid, blood pressure, glycemic, and body mass index outcomes. The authors caution that rankings should be considered alongside effect estimates and confidence ratings, as ranking alone does not establish superiority.

Key findings

• Across 57 trials involving 3655 participants, traditional Chinese training ranked highest for total cholesterol and low-density lipoprotein.
• Aerobic training ranked highest for high-density lipoprotein and diastolic blood pressure; combined training ranked highest for systolic blood pressure and fasting blood glucose.
• Resistance training ranked highest for triglycerides and body mass index, while high-intensity interval training ranked highest for glycated hemoglobin.

Why it matters

The outcome-specific rankings suggest that exercise modalities may not have uniform effects across cardiometabolic measures in older adults. This can inform how exercise options are considered when a particular risk factor is the focus, while the review’s caution about confidence ratings underscores the need to distinguish ranking from reliable evidence of comparative benefit.

What to keep in mind

The authors report sparse comparisons and low or very low confidence ratings for several outcomes, limiting certainty about comparative rankings.