AIM: To synthesize the evidence for using exercise in the management of cognitive symptoms in Parkinson's disease (PD). METHODS: Systematic review and meta-analysis (random-effects model) following the PRISMA statement. We searched on PubMed, Cochrane Library, Scopus, Web of Science, Embase, and PEDro, from May to June 2023. RESULTS: Forty-seven papers were retrieved, and ten studies were included in the meta-analysis. A small-to-moderate effect (-0.40 (95% CI -0.81 to 0.00)) was found for general cognitive function favoring exercise (n = 157). A small effect (-0.30 (-0.58 to -0.02)) was found for executive function, with a sub-group analysis showing a near-significant effect of aerobic exercise in comparison to non-exercise control (-0.39 (-0.80 to 0.02)). CONCLUSIONS: Evidence shows that exercise has an important effect in reducing general and executive cognitive symptoms in PD. The relevance of aerobic exercises, the statistical trends in subdomains, and the quality of the evidence are discussed in this paper.
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