Objective:To lay out the argument that exercise impacts neurobiological targets common to both mood and cognitive functioning, and thus more research should be conducted on its use as an alternative or adjunctive treatment for cognitive impairment in late-life depression (LLD).Method:This narrative review summarizes the literature on cognitive impairment in LLD, describes the structural and functional brain changes and neurochemical changes that are linked to both cognitive impairment and mood disruption, and explains how exercise targets these same neurobiological changes and can thus provide an alternative or adjunctive treatment for cognitive impairment in LLD.Results:Cognitive impairment is common in LLD and predicts recurrence of depression, poor response to antidepressant treatment, and overall disability. Traditional depression treatment with medication, psychotherapy, or both, is not effective in fully reversing cognitive impairment for most depressed older adults. Physical exercise is an ideal treatment candidate based on evidence that it 1) is an effective treatment for depression, 2) enhances cognitive functioning in normal aging and in other patient populations, and 3) targets many of the neurobiological mechanisms that underlie mood and cognitive functioning. Results of the limited existing clinical trials of exercise for cognitive impairment in depression are mixed but overall support this contention.Conclusions:Although limited, existing evidence suggests exercise may be a viable alternative or adjunctive treatment to address cognitive impairment in LLD, and thus more research in this area is warranted. Moving forward, additional research is needed in large, diverse samples to translate the growing research findings into clinical practice.

中文翻译：

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保持健康、敏锐、健康：运动治疗晚年抑郁症认知障碍的案例

目的：提出运动会影响情绪和认知功能所共有的神经生物学目标的论点，因此应该对其作为晚年抑郁症（LLD）认知障碍的替代或辅助治疗方法进行更多研究。方法：这篇叙述性综述总结了有关 LLD 认知障碍的文献，描述了与认知障碍和情绪紊乱相关的大脑结构和功能变化以及神经化学变化，并解释了运动如何针对这些相同的神经生物学变化，从而提供替代或辅助手段结果：认知障碍在 LLD 中很常见，可预测抑郁症复发、抗抑郁治疗反应不佳以及整体残疾。对于大多数抑郁的老年人来说，传统的抑郁症治疗方法包括药物治疗、心理治疗或两者兼而有之，并不能有效地完全逆转认知障碍。体育锻炼是一种理想的治疗方法，因为有证据表明它 1) 是治疗抑郁症的有效方法，2) 可以增强正常衰老过程中和其他患者群体的认知功能，3) 针对构成情绪和认知功能的许多神经生物学机制。现有的有限的运动治疗抑郁症认知障碍的临床试验结果好坏参半，但总体支持这一论点。结论：尽管有限，但现有证据表明运动可能是解决 LLD 认知障碍的可行替代或辅助治疗方法，因此需要更多研究在这个领域是有保证的。展望未来，需要在大量、多样化的样本中进行更多研究，以将不断增长的研究成果转化为临床实践。