Optimal dose and type of exercise to improve depressive symptoms in older adults: a systematic review and network meta-analysis.
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.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.