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Review
. Jul-Sep 2016;38(3):247-54.
doi: 10.1590/1516-4446-2016-1915. Epub 2016 Jul 18.

Exercise for Depression in Older Adults: A Meta-Analysis of Randomized Controlled Trials Adjusting for Publication Bias

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Free PMC article
Review

Exercise for Depression in Older Adults: A Meta-Analysis of Randomized Controlled Trials Adjusting for Publication Bias

Felipe B Schuch et al. Braz J Psychiatry. .
Free PMC article

Abstract

Objective: To evaluate the antidepressant effects of exercise in older adults, using randomized controlled trial (RCT) data.

Methods: We conducted a meta-analysis of exercise in older adults, addressing limitations of previous works. RCTs of exercise interventions in older people with depression (≥ 60 years) comparing exercise vs. control were eligible. A random-effects meta-analysis calculating the standardized mean difference (SMD) (95% confidence interval [95%CI]), meta-regressions, and trim, fill, and fail-safe number analyses were conducted.

Results: Eight RCTs were included, representing 138 participants in exercise arms and 129 controls. Exercise had a large and significant effect on depression (SMD = -0.90 [95%CI -0.29 to -1.51]), with a fail-safe number of 71 studies. Significant effects were found for 1) mixed aerobic and anaerobic interventions, 2) at moderate intensity, 3) that were group-based, 4) that utilized mixed supervised and unsupervised formats, and 5) in people without other clinical comorbidities.

Conclusion: Adjusting for publication bias increased the beneficial effects of exercise in three subgroup analysis, suggesting that previous meta-analyses have underestimated the benefits of exercise due to publication bias. We advocate that exercise be considered as a routine component of the management of depression in older adults.

Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Flowchart of study selection.
Figure 2
Figure 2. Meta-analysis of all included studies. 95%CI = 95% confidence interval; SE = standard error; SMD = standardized mean difference.

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