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

• Main Author: Schuch,Felipe B.
• Publication Date: 2016
• Other Authors: Vancampfort,Davy, Rosenbaum,Simon, Richards,Justin, Ward,Philip B., Veronese,Nicola, Solmi,Marco, Cadore,Eduardo L., Stubbs,Brendon
• Format: Article
• Language: eng
• Source: Brazilian Journal of Psychiatry (São Paulo. 1999. Online)
• Download full: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462016000300247
• topic: Exercise; depression; older adults; publication bias; meta-analysis

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.