Can exercise improve cognition in schizophrenia spectrum disorders? Results from the FitForLife intervention

Cognitive impairment is a core feature in schizophrenia spectrum disorders, strongly associated with daily functioning, and remains difficult to treat. This study aimed to investigate changes in cognitive function following an exercise intervention in individuals with schizophrenia spectrum disorders. Data were derived from a single-arm intervention study conducted across 16 outpatient units in Sweden. The intervention consisted of one circuit training session per week, incorporating both aerobic and muscle-strengthening exercises. Cognitive function was assessed before and after the six-month-long intervention using the Cogstate Schizophrenia Battery (n = 90) and the Trail Making Test (n = 125). Analyses included within-person change summaries, t-tests, effect sizes and regression models. In the Cogstate Schizophrenia Battery, the most prominent changes were an improvement in executive function and declines in psychomotor function and the psychomotor/attention composite. Improvements were observed in both Trail Making Test domains: processing speed/attention and executive function. Greater improvement in VO 2 max was associated with greater improvement in processing speed/attention in the Trail Making Test. These findings suggest that physical exercise may be associated with modest improvements in some aspects of cognitive performance in individuals with SSD, particularly in executive function.