Exercise for depression in older adults: a meta-analysis of randomized controlled trials adjusting for publication bias

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

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.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Depressive Disorder, Major / therapy*
  • Exercise Therapy / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Publication Bias
  • Randomized Controlled Trials as Topic*
  • Risk Factors
  • Treatment Outcome