The Effect of Physical Activity on Executive Functions in the Elderly Population: A Systematic Review of Randomized Controlled Trials

Background/Objectives: In recent years, there has been increasing interest in the scientific, educational, and health sectors in investigating aspects upon which to design physical-activity interventions to prevent cognitive decline, a phenomenon that affects levels of autonomy and quality of life in older adulthood. Physical activity (PA) has been shown to be an effective strategy that can be used to preserve executive functions (EFs) by improving brain flexibility and efficiency. This systematic review aims to identify the most effective strategies used to maintain EF, prevent decline, and promote independence in the elderly. Methods: A systematic literature review was conducted according to PRISMA guidelines. The search was conducted in the following databases: Google Scholar, PubMed, Scopus, and Web of Science; the search used keywords such as "cognitive decline"; "cognitive flexibility"; "elderly"; "executive functions"; "inhibition"; "physical activity"; and "working memory". Experimental studies published between 2019 and 2025 examining the effects of PA on EFs in adults over 60 were selected. After considering the inclusion and exclusion criteria, nine studies were included. The methodological quality of the included studies ranged from moderate to high according to the PEDro scale. Results: The analyzed studies show that short-term interventions positively affect one or two components of EFs, while medium- and long-term interventions produce benefits for all components (working memory, inhibition, and cognitive flexibility). Interventions combined with cognitive stimulation show a greater impact than PA alone. Conclusions: PA is an effective strategy for preserving EFs in the elderly, but the lack of standardized protocols makes it difficult to identify optimal interventions. Further research is needed to more precisely define the most effective intervention approaches.