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Optimal dose and type of exercise to improve depressive symptoms in older adults: a systematic review and network meta-analysis.

BMC geriatrics
January 1, 1970
Lili Tang et al. (13 authors)
Journal ArticleSystematic ReviewMeta-AnalysisHuman Study
Study Details

Study Goal

The researchers aimed to determine the dose-response relationship between Walking and its effectiveness in alleviating depressive symptoms in older adults.

Results Summary

Walking was found to be significantly effective in alleviating depressive symptoms in older adults, even at very low doses. The optimal dose range for Walking was identified as 650–1000 METs-min/week.

Population

Older adults with depressive symptoms.

Effective Dosage

650–1000 METs-min/week.

Duration

Not specified in the abstract.

Interactions

None mentioned.

Extracted Claims (11)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Walking
decrease
depression
older adults
-
was the most effective in alleviating
#1
Aerobic exercise (AE)
decrease
depression symptoms
older adults
1000 METs-min/week
was most effective
#2
Walking
decrease
depressive symptoms
older adults
very low doses
is significantly effective in alleviating
#3
overall exercise
decrease
depressive symptoms
older adults
600 ~ 970 METs-min/week
were clinically effective
#4
Aerobic exercise
decrease
depressive symptoms
older adults
820 ~ 1000 METs-min/week
were found to be effective
#5
Resistance training
decrease
depressive symptoms
older adults
520 ~ 1000 METs-min/week
were found to be effective
#6
Walking
decrease
depressive symptoms
older adults
650 ~ 1000 METs-min/week
were found to be effective
#7
Yoga
decrease
depressive symptoms
older adults
680 ~ 1000 METs-min/week
were found to be effective
#8
exercise
no change
depressive symptoms
older adults
-
did not achieve the effect of alleviating
#9
Walking, AE, Yoga, Qigong, RT, and TC
decrease
depressive symptoms
older adults
-
effectively alleviate
#10
exercise
no change
depressive symptoms
older adults
-
no longer significantly alleviates
#11
Abstract

BACKGROUND: Depression is a prevalent issue among older adults, affecting their quality of life and overall well-being. Exercise is an effective means of relieving depressive symptoms in older adults, but the optimal dose for different exercise types remains unclear. As such, the aim of this meta-analysis was to examine the dose-response relationship between overall and specific types of exercise with depression symptoms in older adults. METHODS: This systematic review and network meta-analysis included a search of PubMed, Medline, Embase, PsycINFO, Cochrane library, and Web of Science for randomized controlled trials of exercise in older adults with depression symptoms from inception to 15 July 2023. Comprehensive data extraction covered dose, treatment regimen, demographics and study duration. Dosage metrics, encompassing METs-min/week, were scrutinized in correlation with the Minimal Clinically Importance Difference (MCID). RESULTS: A total of 47 studies involving 2895 participants and 7 kinds of exercise were included in the review. Without considering the dose, the results of our network meta-analysis indicated that Walking was the most effective in alleviating depression in older adults, in addition to Aerobic exercise (AE), Yoga, Qigong, Resistance training (RT), and Tai Chi (TC), which were equally effective. However, the results of the dose-response analysis found that Aerobic exercise was most effective at a dose of 1000 METs-min/week. It is noteworthy that Walking is significantly effective in alleviating depressive symptoms in older adults at very low doses. In terms of clinical benefits, we found that overall exercise doses in the range of 600 ~ 970 METs-min/week were clinically effective. Considering the specific types of exercise, Aerobic exercise, Resistance training, Walking, and Yoga were found to be effective at doses ranging from 820 ~ 1000 METs-min/week, 520 ~ 1000 METs-min/week, 650 ~ 1000 METs-min/week, 680 ~ 1000 METs-min/week, respectively. At the same time, we found that when the age exceeded 81 years, even when participating in exercise, it did not achieve the effect of alleviating depressive symptoms in older adults. CONCLUSIONS: In conclusion, including Walking, AE, Yoga, Qigong, RT, and TC, effectively alleviate depressive symptoms in older adults. Furthermore, we established statistically and clinically significant threshold doses for various exercise types. Early initiation of exercise is beneficial, but its efficacy diminishes from the age of 80, and beyond 81, exercise no longer significantly alleviates depressive symptoms.

Medical Subject Headings (MeSH)
HumansAgedDepressionNetwork Meta-AnalysisExercise TherapyExerciseRandomized Controlled Trials as Topic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations7
Citations/Year7.0
Relative Citation Ratio3.49
Research Impact Scores
APT Score0.95
Weight Score1.74
Normalized Score0.72
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