Effects of exercise training on cognition in adults with depression: A systematic review and three-level meta-analysis

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2025-04-09 DOI:10.1016/j.ijnurstu.2025.105083

Fei-Fei Ren , Feng-Tzu Chen , Wen-Sheng Zhou , Meng-Yi Tian , Ruei-Hong Li , Dong-Shi Wang , Wen-Ming Liang , Yong Yang , Yu-Kai Chang

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引用次数: 0

Abstract

Background

Cognitive impairment is a central feature of depression. Exercise training has enormous potential as a nonpharmacological intervention to improve cognition in depressed individuals.

Objective

This review aimed to evaluate and update the effect of exercise training on overall cognition and its subdomains, as well as whether moderators influence the effect of exercise training on cognition in depressed adults.

Design

Systematic review and three-level meta-analysis of randomized controlled trials.

Methods

We systematically searched Embase, Ovid MEDLINE, Web of Science, PubMed, and Scopus from their inception to February 14, 2024, and updated the search results on December 5, 2024. Randomized controlled trials investigating how exercise training affected cognition in depressed adults were included. The meta-analysis was performed using a random-effects model in R. We used the Physiotherapy Evidence Database scale to evaluate the study's quality.

Results

Twenty-two studies were included. Exercise training showed statistically significant improvements in overall cognition [g = 0.21; 95 % confidence interval (CI) = 0.12, 0.30] and cognitive subdomains of processing speed (g = 0.20; 95 % CI = 0.04, 0.36), attention (g = 0.21; 95 % CI = 0.06, 0.35), memory (g = 0.24; 95 % CI = 0.11, 0.38), and executive function (g = 0.21; 95 % CI = 0.09, 0.33) compared with comparison groups in depressed adults. The greater cognitive benefits were observed when participants exercised twice a week (g = 0.30; 95 % CI = 0.03, 0.56), at a low intensity (g = 0.26; 95 % CI = 0.08, 0.43), spent more than 60 min per session (g = 0.24; 95 % CI = 0.05, 0.44), 150 min or more per week (g = 0.27; 95 % CI = 0.09, 0.45), had a program duration more than 10 weeks (g = 0.25; 95 % CI = 0.12, 0.39), and engaged in mind–body exercise (g = 0.26; 95 % CI = 0.08, 0.43). The clinical setting, sample size, and comparison group for memory moderated the effects of exercise training on cognition.

Conclusions

Exercise training is an effective nonpharmacological intervention that enhances overall cognition and subdomains of processing speed, attention, memory, and executive function compared with comparison groups in depressed adults. This study only included English-language articles, which may have caused a language bias, and Egger's test revealed a possibility of publication bias.

Registration number

CRD42023457900 (PROSPERO).

Tweetable abstract: Exercise training is an effective nonpharmacological intervention for adults with depression to improve overall cognition and cognitive subdomains of processing speed, attention, memory, and executive function compared with comparison groups.

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运动训练对成人抑郁症患者认知的影响：一项系统综述和三水平荟萃分析

认知障碍是抑郁症的一个主要特征。运动训练作为一种非药物干预手段在改善抑郁症患者的认知方面具有巨大的潜力。目的评估和更新运动训练对抑郁症成人整体认知及其子领域的影响，以及调节因子是否影响运动训练对认知的影响。设计随机对照试验的系统评价和三水平荟萃分析。方法系统检索Embase、Ovid MEDLINE、Web of Science、PubMed、Scopus等数据库自成立至2024年2月14日的检索结果，并于2024年12月5日更新检索结果。研究运动训练如何影响抑郁症成年人认知的随机对照试验也包括在内。meta分析采用随机效应模型进行。我们使用物理治疗证据数据库量表来评估研究的质量。结果共纳入22项研究。运动训练对整体认知的改善有统计学意义[g = 0.21；95%置信区间(CI) = 0.12, 0.30)和认知子域的处理速度(g = 0.20；95% CI = 0.04, 0.36)，注意力(g = 0.21；95% CI = 0.06, 0.35)，记忆(g = 0.24；95% CI = 0.11, 0.38)，执行功能(g = 0.21；95% CI = 0.09, 0.33)。当参与者每周锻炼两次时，观察到更大的认知益处(g = 0.30；95% CI = 0.03, 0.56),低强度(g = 0.26;95% CI = 0.08, 0.43)，每次治疗时间超过60分钟(g = 0.24；95% CI = 0.05, 0.44)，每周150分钟或更长时间(g = 0.27；95% CI = 0.09, 0.45)，项目持续时间超过10周(g = 0.25；95% CI = 0.12, 0.39)，从事身心锻炼(g = 0.26；95% ci = 0.08, 0.43)。临床环境、样本量和记忆的对照组调节了运动训练对认知的影响。结论运动训练是一种有效的非药物干预手段，与对照组相比，运动训练可以提高抑郁症成人的整体认知能力和加工速度、注意力、记忆和执行功能的子领域。这项研究只包括英语文章，这可能会导致语言偏差，埃格的测试揭示了发表偏差的可能性。注册号crd42023457900（普洛斯彼罗）。摘要：与对照组相比，运动训练是一种有效的非药物干预方法，可以改善成人抑郁症患者的整体认知和认知子领域的处理速度、注意力、记忆力和执行功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).