SYSTEMATIC REVIEW article
Front. Public Health
Sec. Public Mental Health
This article is part of the Research TopicCognitive impairments in schizophrenia, bipolar disorder, and major depression: Dissecting common and divergent featuresView all 15 articles
Optimal dose and type of exercise to improve Cognitive Function in Adults with Major Depressive Disorder:A Systematic Review and Bayesian Model-based Network Meta-analysis
Provisionally accepted
- 1Sports Science Institution, Nanjing University, Nanjing, China
- 2College of Physical Education, Yangzhou University, Yangzhou, China
- 3Institute of Sports Science, Nantong University, Nantong, China
- 4Department of Physical Education, Nanjing University, Nanjing, China
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Introduction: Cognitive impairment is a core feature of Major Depressive Disorder (MDD) that often persists during remission, significantly affecting psychosocial functioning. While exercise is known to alleviate depressive symptoms, its specific impact on cognitive domains remains variable. This study aims to evaluate the dose-response relationship and comparative effectiveness of different types of exercise interventions on cognitive function in adults with MDD. Methods: Five electronic databases (Ovid Medline, PsycINFO, Web of Science, Cochrane Central, and Embase) were systematically searched on September 20, 2024. Study Selection:Randomized controlled trials (RCTs) involving adults aged 18 years or older with MDD were included if they examined the effects of exercise interventions and reported at least one cognitive outcome. Two independent reviewers conducted data extraction and quality assessment according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Network Meta-Analyses (PRISMA-NMA) guidelines. Results: A three-level meta-analysis and a Bayesian model-based network meta-analysis were performed. Fifteen RCTs with a total of 1,196 participants were included. A non-linear dose-response relationship was observed, with a minimum effective dose of 967 METs-min/week—within the WHO-recommended exercise range. Among exercise types, Tai Chi/Qigong demonstrated the greatest cognitive benefits. Moderation analysis indicated that younger age and a higher proportion of female participants were associated with stronger cognitive effects. Conclusions: Exercise significantly improves cognitive function in adults with MDD, with aerobic and mind-body exercises offering particularly strong benefits. These results support the integration of tailored exercise programs into treatment strategies for cognitive dysfunction in MDD.
Keywords: Exercise, Cognition, Major Depressive Disorder, dose-response, Bayesian model
Received: 09 Jul 2025; Accepted: 10 Dec 2025.
Copyright: © 2025 Ge, Wang, Wang, XUAN and Zhai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
XIONG XUAN
Yifei Zhai
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