A Multi-Criteria Decision Analysis of Open-Skill Exercise-Based Sports for Cognitive Health Promotion in Older Adults

Cognitive decline and dementia are major challenges in aging societies. Open-skill exercise (OSE), characterized by unpredictable environments requiring rapid perceptual–cognitive–motor adaptation, has emerged as a promising approach for cognitive health. However, systematic cross-sport comparisons remain scarce. This study evaluated eight OSEs—tennis, table tennis, badminton, basketball, volleyball, soccer, baseball, and non-combat judo—using a multidimensional framework to assess their relative suitability for cognitive health promotion and community implementation among older adults. A multi-criteria decision analysis was conducted using eight criteria covering key cognitive, physical, social, safety, operational, sustainability, and digital aspects. Cognitive load was quantified using an established composite metric, with all criteria normalized and weighted for dementia prevention relevance. Weighted scores were integrated to generate an overall composite suitability score for each sport. Table tennis achieved the highest score, reflecting strong performance across cognitive, physical, safety, feasibility, sustainability, and digital domains. Badminton also scored highly, driven by strong cognitive and practical attributes. Team sports showed broad cognitive demands and high social interaction but were limited by lower individual decision frequency or elevated injury risk. Soccer and basketball had high physical load, whereas baseball and non-combat judo scored lower due to comparatively limited real-time cognitive demands and feasibility constraints. Overall, OSEs differed markedly across cognitive, physical, and operational domains. Table tennis emerged as a highly scalable and well-balanced option for cognitive health interventions in older adults, followed by badminton and selected team sports. These findings provide guidance for community programming and future neurocognitive and implementation-oriented research. Taken together, these multidimensional characteristics suggest potential relevance to the prevention of cognitive, physical, and social frailty.