Guo Xiao-Zhen, Liu Cong, Wang Jing, Liu Hai-Rong
Department of Physical Education, Tongji University, Shanghai 200092, China.
School of Physical Education, Shanghai University of Sport, Shanghai 200438, China.
World J Psychiatry. 2024 Oct 19;14(10):1558-1572. doi: 10.5498/wjp.v14.i10.1558.
Major depressive disorder is a common mental disorder, characterized by a high rate of suicide and recurrence, which is frequently accompanied by cognitive impairments, particularly in executive function, memory, attention, and information processing speed. As such, improving the cognitive function in patients with depression and enhancing their quality of life are urgent issues.
To perform a systematic review and meta-analysis of the effects of exercise on cognitive function in patients with depression.
The PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Medical, VIP, and Biomedical Databases for randomized controlled trials (RCTs) databases were searched (from inception to October 19, 2023) for studies investigating improvements in cognitive function in patients with depression through exercise. Tools recommended by the Cochrane Handbook for RCT evaluation, and GRADEpro and Stata17 software, were employed for risk of bias assessment, evidence grading, forest plot construction, subgroup and sensitivity analyses, and assessment of publication bias.
Seventeen RCTs (1173 patients with depression) were included. Exercise had a small but significant positive effect on attention, with an effect size of 0.21, 95%CI: 0.07-0.34, < 0.01. Specifically, aerobic exercise regimens of 30-60 minute/session, thrice a week, at moderate intensity, and sustained over 3-12 weeks, were associated with the most pronounced benefits ( < 0.05), with effect sizes for executive function, memory, and information processing speed of 0.11, 95%CI: -0.11-0.32, = 0.34; 0.08, 95%CI: 0.00-0.16, = 0.05; and 0.14, 95%CI: 0.04-0.25, = 0.01, respectively. The evidence levels for attention, information processing speed, and memory were rated as 'low,' whereas that for executive function was rated as 'very low'.
Exercise could improve attention and information-processing speed in patients with depression, although improvements in executive function and memory are not significant.
重度抑郁症是一种常见的精神障碍，其特点是自杀率和复发率高，常伴有认知障碍，尤其是执行功能、记忆、注意力和信息处理速度方面的障碍。因此，改善抑郁症患者的认知功能并提高其生活质量是亟待解决的问题。
对运动对抑郁症患者认知功能的影响进行系统评价和荟萃分析。
检索了PubMed、Web of Science、Cochrane图书馆、Embase、中国知网、万方医学、维普和随机对照试验（RCT）数据库的生物医学数据库（从创建到2023年10月19日），以查找通过运动改善抑郁症患者认知功能的研究。采用Cochrane手册推荐的RCT评估工具以及GRADEpro和Stata17软件进行偏倚风险评估、证据分级、森林图构建、亚组分析和敏感性分析以及发表偏倚评估。
纳入了17项RCT（1173例抑郁症患者）。运动对注意力有微小但显著的积极影响，效应大小为0.21，95%CI：0.07 - 0.34，P < 0.01。具体而言，每次30 - 60分钟、每周三次、中等强度且持续3 - 12周的有氧运动方案带来的益处最为显著（P < 0.05），执行功能、记忆和信息处理速度的效应大小分别为0.11，95%CI： - 0.11 - 0.32，P = 0.34；0.08，95%CI：0.00 - 0.16，P = 0.05；以及0.14，95%CI：0.04 - 0.25，P = 0.01。注意力、信息处理速度和记忆的证据水平被评为“低”，而执行功能的证据水平被评为“非常低”。
运动可以改善抑郁症患者的注意力和信息处理速度，尽管执行功能和记忆的改善不显著。
