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


Author: Lili Tang1, Lin Zhang2, Yanbo Liu3, Yan Li1, Lijuan Yang4, Mingxuan Zou5, Huiran Yang1, Lingyu Zhu1, Ruihong Du1, Ye Shen1, Haoyu Li6, Yong Yang7, Zhijun Li8

Affiliation: <sup>1</sup> Department of Epidemiology, School of Public Health, Beihua University, No. 3999 Binjiang Road, Jilin, 132000, Jilin Province, China.

<sup>2</sup> Department of Rehabilitation, West China Hospital Sichuan University Jintang Hospital, Chengdu City, Sichuan Province, China.

<sup>3</sup> The Pathophysiology Department of Basic Medical College, Beihua University, Jilin City, 132000, Jilin Province, China.

<sup>4</sup> Basic Medical School Biochemistry, Beihua University, 132000, Jilin City, Jilin Province, China.

<sup>5</sup> National Energy, Jilin, Jilin Province, China.

<sup>6</sup> Shenyang Railway Disease Control Center, Jilin, Jilin Province, China.

<sup>7</sup> Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, 475001, Henan Province, China.

<sup>8</sup> Department of Epidemiology, School of Public Health, Beihua University, No. 3999 Binjiang Road, Jilin, 132000, Jilin Province, China. zjli15@beihua.edu.cn.
Conference/Journal: BMC Geriatr
Date published: 2024 Jun 7
Other:
 Volume ID: 24   ,  Issue ID: 1   ,  Pages: 505   ,  Special Notes: doi: 10.1186/s12877-024-05118-7.   ,  Word Count: 378  
    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.



Keywords: Depressive symptoms; Dose–response relationship; Exercise; Older adults.



PMID: 38849780 PMCID: PMC11157862 DOI: 10.1186/s12877-024-05118-7