This study aims to systematically evaluate the effects of exercise on cognitive function in individuals with Down syndrome (DS) through a comprehensive systematic review and meta-analysis. Five electronic databases (PubMed, Embase, Cochrane Library, Web of Science, and SPORTDiscus) were systematically searched from inception to February 10, 2025. Additional studies were identified through manual reference screening. Meta-analyses were performed using Stata 17.0. Exercise interventions were associated with significant improvements in cognitive function among individuals with DS (standardized mean difference = 0.50; 95% CI: 0.33,0.67; P < 0.01). Subgroup analyses revealed consistent benefits across cognitive domains, age groups, exercise intensities, and sample sizes. However, no significant effects were observed for interventions involving treadmill walking or single-session exercise. No substantial heterogeneity was detected within any subgroup, supporting the robustness of the findings. Conclusion : This systematic review and meta-analysis provide strong evidence that exercise is an effective strategy for enhancing cognitive function in individuals with DS. The consistency of the results across subgroups supports their generalizability. Future studies should focus on the long-term effectiveness and methodological quality of interventions to refine exercise-based strategies for cognitive rehabilitation in this population.
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