兰州大学循证社会科学交叉创新实验室 Innovation Laboratory of Evidence-based Social Sciences,Lanzhou University

Non-pharmacological interventions for older adults with depressive symptoms: a network meta-analysis of 35 randomized controlled trials

Xuemei Han; Long Ge
2019-12-26
Objective: To assess the effectiveness of non-pharmacological interventions for seniors with depressive symptoms. Methods: A comprehensive literature search was performed. We conducted network meta-analysis in two ways, intervention classes (psychosocial, psychotherapy, physical activity, combined, treatment as usual) and individual intervention (11 categories). Whenever included studies used different scales, the different instruments were converted to the units of the scale most frequently used (the Geriatric Depression Scale), such that the effect size was reported as a mean difference (MD) with 95% confidence interval (CI). The risk of bias of RCTs included in this review was assessed according to the Cochrane Handbook. Bayesian NMA was conducted using R-3.4.0 software. Results: A total of 35 RCTs with 3,797 enrolled patients were included. Compared to conventional treatment, physical activity and psychotherapy resulted in significant improvements in depressive symptoms (MD: 2.25, 95%CrI: 0.99-3.56; SUCRA = 86.07%; MD: 1.75, 95% CrI: 0.90-2.64; SUCRA = 66.44%, respectively). Similar results were obtained for music (MD: 2.6; 95% CrI: 0.84-4.35;SUCRA = 80.53%), life review (MD:1.92; 95% CrI:0.71-3.14; SUCRA = 65.62%), cognitive behavioral therapy (MD: 1.27; 95% CrI: 0.23-2.38; SUCRA = 45.4%), aerobic (MD: 1.84; 95% CrI: 0.39-3.36; SUCRA = 63%) and resistance training (MD: 1.72; 95% CrI: 0.06-3.42; SUCRA = 59.24%). Network meta-regression showed that there were no statistically significant subgroup effects. Conclusions: Physical activity and psychotherapy demonstrated statistically significant superiority over conventional treatment. Music and life review therapy proved the most promising individual interventions. However, conclusions are limited by the lack of sufficient sample size and consensus regarding intervention categories and so an adequately powered study is necessary to consolidate these findings.
Aging & Mental Health
卷号:25|期号:5|页码:773-786
ISSN:1360-7863|收录类别:SCIE
DOI
10.1080/13607863.2019.1704219
EISSN
1364-6915
出版日期
2019-12-26
资助信息
This work was supported by the China Medical Board [CMB17–279]; the Fundamental Research Funds for the Central Universities [16LZUJBWTD013, 18LZUJBWZX006, and lzujbky-2018-14]; Gansu Soft Science Project [18CX1ZA043]; and 2015 Gansu Social Science Planning Project [YB004]
相关链接
https://www.tandfonline.com/doi/full/10.1080/13607863.2019.1704219
语种
英文
国家
中国
学科领域
循证医学
被引频次(WOS)
35
来源机构
Evidence-Based Social Science Center, Lanzhou University, Lanzhou Gansu, China
研究类型
Meta分析
关键词
depression older adults non-pharmacological intervention network meta-analysis
资助机构
中华医学会 财政部和教育部 甘肃省科技厅 甘肃省哲学社会科学规划项目管理办公室
WOS学科分类
Geriatrics Gerontology Gerontology Psychiatry