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Purpose Although cross-sectional studies have demonstrated an association between higher levels of aerobic fitness and improved neurocognitive function, there have been relatively few interventional studies investigating this relationship, and results have been inconsistent. We assessed the effects of aerobic exercise on neurocognitive function in a randomized controlled trial of patients with major depressive disorder (MDD). Methods Two-hundred and two sedentary men (n = 49) and women (n = 153), aged 40 yr and over and who met diagnostic criteria for MDD, were randomly assigned to the following: a) supervised exercise, b) home-based exercise, c) sertraline, or d) placebo pill. Before and after 4 months of treatment, participants completed measures of: Executive Function (Trail Making Test B-A difference score, Stroop Color/Word, Ruff 2 & 7 Test, Digit Symbol), Verbal Memory (Logical Memory, Verbal Paired Associates), and Verbal Fluency/Working Memory (Animal Naming, Controlled Oral Word Association Test, Digit Span). Multivariate analyses of covariance were performed to test the effects of treatment on posttreatment neuropsychological test scores, with baseline neuropsychological test scores, age, education, and change in depression scores entered as covariates. Results The performance of exercise participants was no better than participants receiving placebo across all neuropsychological tests. Exercise participants performed better than participants receiving sertraline on tests of executive function but not on tests of verbal memory or verbal fluency/working memory. Conclusions We found little evidence to support the benefits of an aerobic exercise intervention on neurocognitive performance in patients with MDD.

This qualitative study was undertaken to clarify an emerging explanatory model of health-promoting behaviors, and quality of life in individuals with chronic disabling conditions. Twenty individuals with multiple sclerosis shared their stories regarding health promotion, domains of quality of life, and factors that affected these domains. Health-promoting behaviors were viewed as essential to the process of rehabilitation and maintaining an acceptable quality of life. Important quality-of-life issues were related to domains other than function. Implications are that health promotion efforts need to be encouraged and supported in individuals with chronic disabling conditions.