Cognitive decline is age-specific or related to dementia and Alzheimer's disease (AD), which poses great concern to older adults. Exercise contributes to cognitive gains, with aerobic exercise (AE) being the most commonly studied type. However, other types, such as resistance exercise (RE), have received less attention in exercise-cognition research. This narrative review aims to synthesize evidence addressing the effects of RE, including the influence of its various parameters on cognitive function in older adults. It also examines the adaptations of neurotrophic factors, brain structure, and brain function in response to RE and explores the relationship between these adaptive responses and cognitive function. A comprehensive search of PubMed databases was conducted up to Jan 2025, identifying 41 randomized controlled trials for inclusion. RE may effectively improve executive function, memory function, and global cognition in older adults with and without cognitive impairment. However, optimal exercise parameters, such as intensity, frequency, and length, remain to be established. Evidence suggests that RE may elevate peripheral insulin-like growth factor 1 levels, increase gray matter thickness, mitigate hippocampal atrophy, and enhance brain activation, all of which appear to contribute to cognitive improvements. Collectively, these studies advance our understanding of the potential role of RE in promoting cognitive and brain health during aging.
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