Abstract
OBJECTIVE: This study sought to comprehensively assess the impact of aerobic exercise on cognitive performance and depressive symptoms in individuals diagnosed with depression, in order to provide a more comprehensive evidence base for the clinic. METHODS: PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Data, and SinoMed were searched for randomized controlled trials (RCTs) published up to June 2025. Eligible studies included clinically diagnosed patients with depression receiving aerobic exercise as the intervention. Meta-analyses were conducted using RevMan 5.4. Standardized mean differences (SMD) were pooled as effect sizes. Heterogeneity was assessed using the I(2) statistic. The Cochrane Risk of Bias 1.0 tool was used to assess methodological quality. RESULTS: A total of 17 RCTs were included. According to the results of the meta-analysis, aerobic exercise was associated with marked enhancements in working memory (Digit Span Backward, SMD = 0.16, P = 0.05) and executive function (Trail Making Test-B, SMD = -0.29, P = 0.03) in patients with depression. Notably, as comprehensive cognitive assessment tools, the Montreal Cognitive Assessment and the Mini-Mental State Examination demonstrated significant effects of aerobic exercise (SMD = 1.68, P = 0.0003). Regarding depressive symptoms, significant improvement was found with the Hamilton Depression Rating Scale (SMD = -0.87, P = 0.04). Additionally, four studies reported unique single-scale outcomes suggesting potential trends toward improvement in both cognitive and emotional domains. CONCLUSION: Engagement in aerobic exercise appears to support improvements in executive function and working memory among patients with depression, though its impact on other cognitive domains and mood-related outcomes remains inconclusive. These findings should be interpreted with caution.