The Effectiveness of Horticultural Therapy on Older Adults: A Systematic Review

J Am Med Dir Assoc. 2019 Oct;20(10):1351.e1-1351.e11. doi: 10.1016/j.jamda.2019.06.021. Epub 2019 Aug 8.


Objectives: Although the therapeutic effects of horticulture on older adults have been widely investigated, a recent and comprehensive synthesis of available evidence on outcomes is lacking. We systematically reviewed evidence for the therapeutic effects of horticulture on older adults.

Design: A systematic search of PubMed, MEDLINE, Sage Journals, ProQuest, Science Direct, and CINAHL was conducted. Articles were selected if they were quantitative studies published in English from 2008 to 2018.

Setting and participants: Articles were selected if they included participants aged 60 years and older and used horticulture as the main intervention.

Measures: Experimental studies were appraised using the Physiotherapy Evidence Database Scale.

Results: The systematic search yielded 20 articles. Significant pre-post improvement was reported in quality of life, anxiety, depression, social relations, physical effects, and cognitive effects. However, between-group results were lacking or nonsignificant.

Conclusions and implications: There is evidence for benefits of horticulture among older adults, particularly in long-term care facilities. Nonetheless, as the robustness of evidence is lacking, more rigorous randomized controlled trials and between-group effects need to be investigated.

Keywords: Horticultural therapy; aged; elderly; gardening; older adults; therapeutic horticulture.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Depression
  • Female
  • Horticultural Therapy*
  • Humans
  • Male
  • Quality of Life
  • Treatment Outcome*