John Sealy School of Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, USA.
Mitchell Center for Neurodegenerative Diseases, Department of Neurology, University of Texas Medical Branch at Galveston, Galveston, TX, USA.
J Alzheimers Dis. 2022;89(3):759-767. doi: 10.3233/JAD-210632.
Alzheimer's disease (AD) and major depressive disorder (MDD) affect millions worldwide and both cause significant morbidity and mortality. While clinically distinctive, patients with MDD can present with memory dysfunction and patients with AD commonly report symptoms of depression. Additionally, brain pathology in MDD and AD both demonstrate decreased hippocampal volumes, and severe disease is associated with smaller hippocampal volumes in both disorders. Hippocampal neurogenesis occurs daily in healthy individuals, an impaired process in AD and MDD. MDD is thus suggested to be a risk factor for developing AD later in life; moreover, depression onset alongside AD indicates a worse prognosis. Treatment options that target hippocampal neurogenesis are being evaluated for both diseases, and aerobic exercise has shown promising results. We searched PubMed for relevant review articles published since 2000 encompassing the topics of hippocampal neurogenesis and exercise in relation to depression and AD, including novel clinical trials if they contributed information not in the chosen reviews. While much data indicates that exercise increases hippocampal neurogenesis in both MDD and AD, mood improvement in MDD, mild quality of life and cognitive improvement in AD, and reduced risk of those with MDD developing AD in response to various exercise regimens, this result was not universal. Some data indicated no difference between exercise groups and controls. Further randomized control trials into exercise as an intervention in treating MDD and preventing AD is required. However, exercise is a low-risk, affordable treatment option and is a feasible additive therapy in patients with AD and MDD.
阿尔茨海默病（AD）和重度抑郁症（MDD）影响着全球数以百万计的人，两者都导致了巨大的发病率和死亡率。虽然临床上有明显的区别，但 MDD 患者可能会出现记忆功能障碍，而 AD 患者常报告有抑郁症状。此外，MDD 和 AD 的大脑病理学都表现出海马体积减小，严重疾病与两种疾病中的海马体积减小有关。在健康个体中，海马神经发生每天都在发生，而 AD 和 MDD 中则存在该过程受损。因此，MDD 被认为是晚年发生 AD 的一个危险因素；此外，AD 伴随抑郁发作表明预后更差。针对这两种疾病，正在评估针对海马神经发生的治疗选择，而有氧运动已显示出有希望的结果。我们在 PubMed 上搜索了自 2000 年以来发表的与海马神经发生和与抑郁及 AD 相关的运动相关的综述文章，包括新的临床试验，如果它们提供了所选综述中没有的信息。虽然大量数据表明，运动可以增加 MDD 和 AD 患者的海马神经发生，但 MDD 的情绪改善、AD 的轻度生活质量和认知改善，以及 MDD 患者在各种运动方案下对 AD 的发病风险降低，但并非所有结果都如此。一些数据表明运动组和对照组之间没有差异。需要进一步进行随机对照试验，以评估运动作为治疗 MDD 和预防 AD 的干预措施。然而，运动是一种低风险、负担得起的治疗选择，并且是 AD 和 MDD 患者可行的附加治疗方法。
