Systematic review finds aerobic exercise improves executive function in adults with major depressive disorder
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Key Takeaway
Consider aerobic exercise as a promising nonpharmacological therapy to improve executive function in adults with MDD.
This systematic review and three-level meta-analysis assessed the impact of aerobic exercise on executive function in adults with major depressive disorder. The review synthesized data from studies where interventions were conducted three times weekly at moderate and vigorous intensities, lasting 45 minutes per session and 90 to 149 minutes weekly over 3 to 10 weeks or longer. The follow-up period averaged 2.3 months.
Results indicated that overall core executive function improved significantly with a standardized mean difference of g = 0.14 and a 95% CI of 0.05 to 0.22. Inhibitory control improved significantly with a g of 0.19, and cognitive flexibility improved with a g of 0.17. Working memory showed a g of 0.08 but did not achieve statistical significance.
The authors note that adverse events, serious adverse events, discontinuations, and tolerability were not reported in the source data. Funding or conflicts of interest were also not reported. The authors conclude that aerobic exercise is a promising nonpharmacological therapy to improve overall core executive function and its subdomains of inhibitory control and cognitive flexibility in this population.
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View Original Abstract ↓
This study aimed to investigate the effects of aerobic exercise (AE) on overall core executive function (EF) and its subdomains in adults with major depressive disorder (MDD). We systematically searched Embase, Ovid MEDLINE, Web of Science, Scopus, and PubMed up to October 12, 2024. We included randomized controlled trials (RCTs) that investigated the effects of AE on core EF in adults with MDD. We conducted a three-level meta-analysis with a random-effects model in R and used the Physiotherapy Evidence Database scale to assess study quality. Ten RCTs involving 780 depressed adults were included. AE statistically significantly improved overall core EF (g = 0.14; 95% confidence intervals [CI] = 0.05, 0.22; p = 0.004) and its subdomains of inhibitory control (g = 0.19; 95% CI = 0.07, 0.32; p = 0.004) and cognitive flexibility (g = 0.17; 95% CI = 0.01, 0.33; p = 0.043), but not working memory (g = 0.08; 95% CI = -0.01, 0.17; p = 0.070) in adults with MDD. Aerobic exercise, conducted three times weekly at moderate and vigorous intensities (45 min per session, 90-149 min weekly) and over 3-10 weeks or longer, can improve the overall core EF in adults with MDD. This study found that AE is a promising nonpharmacological therapy to improve the overall core EF and its subdomains of inhibitory control and cognitive flexibility in adults with MDD. AE plus antidepressants and the percentage of females were significant moderators.
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