Use of multicomponent structured exercise to improve depression in older adults: A systematic review and meta-analysis

Objective: To summarize the characteristics, estimate the efficacy of multicomponent structured exercise (MSE) intervention on older adults’ depression, and investigate its potential moderators. Methods: MEDLINE, PubMed, PsycINFO, SPORTDiscus, Web of Science and Embase databases were searched from January 1, 2000 to June 1, 2024. Randomized controlled trials (RCTs) that included MSE intervention with aerobic, resistance and balance components targeting older adults, and reported depression as an outcome were selected. Random-effects meta-analyses were used to calculate effect sizes from the standardized mean difference (SMD) and 95 % confidence intervals (CIs). Meta-regression was conducted to identify the potential moderators. 

Results: Data were extracted from 19 studies (22 comparisons) with 1763 older adults. MSE showed a significant intervention effect on buffering older adults' depression (SMD, −0.49; 95 % CI, −0.84 to −0.14) but with considerable heterogeneity (I² = 92 %) and low certainty of evidence. In subgroup analyses, MSE with unhealthy status participants, intervention duration of 12–24 weeks, over 2 times/week intervention frequency, equipment used and ≥ 80 % retention rate showed significant effects on improvement of older adults’ depression. Intervention frequency (β, −0.83; 95 % CI, −1.50 to −0.16) and retention rate (β, 0.80; 95 % CI, 0.05 to 1.56) were identified as moderators. 

Conclusion: MSE significantly improved older adults’ depression. The findings highlighted the importance of intervention frequency and retention rate in enhancing MSE effectiveness. More high quality RCTs are required to explore and optimize the intervention strategies and dosages of MSE to extend the application in the prevention and treatment of geriatric depression.