BACKGROUND: Late-life depression (LLD) poses a significant public health challenge, profoundly affecting cognitive function and emotional well-being in the elderly. Current pharmacological treatments often have side effects, increasing interest in non-pharmacological interventions. OBJECTIVE: This study evaluates the effectiveness of a 12-week aerobic, strength, or balance training intervention on depressive symptoms and cognitive function in older adults with mild to moderate LLD while also investigating the impact of different training frequencies (3x/week or 5x/week). METHODS: We conducted a randomized controlled trial (RCT) involving 121 community-dwelling older adults aged 60 years and above diagnosed with mild to moderate LLD. Stratified randomization will be conducted based on baseline depression severity and key characteristics, dividing patients into the intervention groups (drug therapy and standard care combined with aerobic exercise, strength training, or balance training interventions, respectively) and the control group (drug therapy and standard care). The exercise intervention comprised aerobic, strength or balance exercises conducted 3x/week or 5x/week. Depression severity and cognitive function were assessed using the Hamilton Depression Rating Scale (HAMD-17) and Mini-Mental State Examination (MMSE) at baseline, after 12 weeks, and after a four-week follow-up. Additionally, physiological parameters, including weight, blood pressure (systolic and diastolic), resting heart rate, and fasting blood glucose levels, were assessed simultaneously to evaluate overall health improvements. Statistical analysis was performed using repeated measures ANOVA to assess within- and between-group changes. RESULTS: The intervention group significantly improved depressive symptoms, cognitive function, and physiological parameters. Specifically, the HAMD-17 scores decreased by 6.5 +/- 2.8 points (p < 0.001), while the MMSE scores increased by 5.7 +/- 2.4 points (p < 0.001), indicating reduced depressive symptom severity and improved cognitive function, respectively. These improvements were significantly greater than those observed in the control group. Notably, high-frequency aerobic exercise (5x/week) yielded the most significant benefits, showing a reduction of 8.6 +/- 2.7 points in HAMD-17 and an increase of 6.8 +/- 2.1 points in MMSE (both p < 0.001). CONCLUSION: The aerobic, strength, or balance training regimen effectively reduces depressive symptoms and improves cognitive function in older adults with LLD, offering a promising non-pharmacological treatment option. This study underscores the potential of exercise interventions to complement traditional therapies, paving the way for more holistic treatment strategies for late-life depression.

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