Influence of aerobic exercise on the cognitive and social functions of elderly patients with schizophrenia

BACKGROUND Schizophrenia presents complex challenges in older patients due to cognitive and social decline. Existing drug treatments offer limited benefits and pose risks, while aerobic exercise shows promise as a noninvasive intervention whose impact remains underexplored. AIM To investigate the effects of aerobic exercise on cognitive and social function in older patients with schizophrenia. METHODS A retrospective study was conducted in 158 older patients with schizophrenia treated at The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College (June 2023 and December 2024). The patients were divided into an observation group (n = 86), which received 3 months of aerobic rehabilitation alongside routine treatment, and a control group (n = 72), which received routine treatment alone. Cognitive function was assessed using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery, social function using the Inpatient Psychiatric Rehabilitation Outcome Scale (IPROS), and psychotic symptoms using the Positive and Negative Syndrome Scale. RESULTS Post-treatment, Positive and Negative Syndrome Scale total scores were lower in the observation group than in the controls (P < 0.001), with significant improvements in positive, negative, and general symptoms. Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery domain scores were improved in processing speed, working memory, verbal/visual learning, and executive function (all P < 0.05). IPROS total scores were decreased (P < 0.001), indicating better social functioning. Longer exercise duration correlated with greater cognitive gains and lower social function deficits. Body mass index declined (P < 0.001), and adverse events were mild and transient (9.3%). Multivariate linear regression confirmed that aerobic exercise was independently associated with a significant reduction in IPROS scores (Adjusted β = -4.57, 95% confidence intervals: -6.08 to -3.05, P < 0.001). CONCLUSION Aerobic exercise effectively improves cognitive function, social function, and psychotic symptoms in older patients with schizophrenia, is safe, and serves as a valuable adjunctive intervention.