PDF(Pubmed)
Abstract：
BACKGROUND: Depression is a prevalent issue among older adults, affecting their quality of life and overall well-being. Exercise is an effective means of relieving depressive symptoms in older adults, but the optimal dose for different exercise types remains unclear. As such, the aim of this meta-analysis was to examine the dose-response relationship between overall and specific types of exercise with depression symptoms in older adults.
METHODS: This systematic review and network meta-analysis included a search of PubMed, Medline, Embase, PsycINFO, Cochrane library, and Web of Science for randomized controlled trials of exercise in older adults with depression symptoms from inception to 15 July 2023. Comprehensive data extraction covered dose, treatment regimen, demographics and study duration. Dosage metrics, encompassing METs-min/week, were scrutinized in correlation with the Minimal Clinically Importance Difference (MCID).
RESULTS: A total of 47 studies involving 2895 participants and 7 kinds of exercise were included in the review. Without considering the dose, the results of our network meta-analysis indicated that Walking was the most effective in alleviating depression in older adults, in addition to Aerobic exercise (AE), Yoga, Qigong, Resistance training (RT), and Tai Chi (TC), which were equally effective. However, the results of the dose-response analysis found that Aerobic exercise was most effective at a dose of 1000 METs-min/week. It is noteworthy that Walking is significantly effective in alleviating depressive symptoms in older adults at very low doses. In terms of clinical benefits, we found that overall exercise doses in the range of 600 ~ 970 METs-min/week were clinically effective. Considering the specific types of exercise, Aerobic exercise, Resistance training, Walking, and Yoga were found to be effective at doses ranging from 820 ~ 1000 METs-min/week, 520 ~ 1000 METs-min/week, 650 ~ 1000 METs-min/week, 680 ~ 1000 METs-min/week, respectively. At the same time, we found that when the age exceeded 81 years, even when participating in exercise, it did not achieve the effect of alleviating depressive symptoms in older adults.
CONCLUSIONS: In conclusion, including Walking, AE, Yoga, Qigong, RT, and TC, effectively alleviate depressive symptoms in older adults. Furthermore, we established statistically and clinically significant threshold doses for various exercise types. Early initiation of exercise is beneficial, but its efficacy diminishes from the age of 80, and beyond 81, exercise no longer significantly alleviates depressive symptoms.
METHODS: This systematic review and network meta-analysis included a search of PubMed, Medline, Embase, PsycINFO, Cochrane library, and Web of Science for randomized controlled trials of exercise in older adults with depression symptoms from inception to 15 July 2023. Comprehensive data extraction covered dose, treatment regimen, demographics and study duration. Dosage metrics, encompassing METs-min/week, were scrutinized in correlation with the Minimal Clinically Importance Difference (MCID).
RESULTS: A total of 47 studies involving 2895 participants and 7 kinds of exercise were included in the review. Without considering the dose, the results of our network meta-analysis indicated that Walking was the most effective in alleviating depression in older adults, in addition to Aerobic exercise (AE), Yoga, Qigong, Resistance training (RT), and Tai Chi (TC), which were equally effective. However, the results of the dose-response analysis found that Aerobic exercise was most effective at a dose of 1000 METs-min/week. It is noteworthy that Walking is significantly effective in alleviating depressive symptoms in older adults at very low doses. In terms of clinical benefits, we found that overall exercise doses in the range of 600 ~ 970 METs-min/week were clinically effective. Considering the specific types of exercise, Aerobic exercise, Resistance training, Walking, and Yoga were found to be effective at doses ranging from 820 ~ 1000 METs-min/week, 520 ~ 1000 METs-min/week, 650 ~ 1000 METs-min/week, 680 ~ 1000 METs-min/week, respectively. At the same time, we found that when the age exceeded 81 years, even when participating in exercise, it did not achieve the effect of alleviating depressive symptoms in older adults.
CONCLUSIONS: In conclusion, including Walking, AE, Yoga, Qigong, RT, and TC, effectively alleviate depressive symptoms in older adults. Furthermore, we established statistically and clinically significant threshold doses for various exercise types. Early initiation of exercise is beneficial, but its efficacy diminishes from the age of 80, and beyond 81, exercise no longer significantly alleviates depressive symptoms.
摘要：
背景：抑郁症是老年人中普遍存在的问题，影响他们的生活质量和整体福祉。运动是缓解老年人抑郁症状的有效手段,但不同运动类型的最佳剂量仍不清楚.因此，本荟萃分析的目的是研究老年人整体和特定运动类型与抑郁症状之间的剂量-反应关系.
方法：本系统综述和网络荟萃分析包括搜索PubMed，Medline,Embase,PsycINFO,科克伦图书馆,和WebofScience对从开始到2023年7月15日有抑郁症状的老年人进行运动的随机对照试验。综合数据提取覆盖剂量，治疗方案，人口统计学和研究持续时间。剂量指标，包括MET-分钟/周，与最小临床重要性差异(MCID)相关进行了审查。
结果：共纳入47项研究，涉及2895名参与者和7种运动。不考虑剂量,我们的网络荟萃分析结果表明，步行是最有效的缓解老年人的抑郁症，除了有氧运动（AE），瑜伽,气功,阻力训练(RT),太极拳（TC），同样有效。然而,剂量-反应分析的结果发现,有氧运动在1000METs-min/周的剂量下最有效.值得注意的是，在非常低的剂量下，步行对缓解老年人的抑郁症状非常有效。就临床效益而言，我们发现600~970METs-min/周的总运动剂量是临床有效的.考虑到运动的具体类型，有氧运动,抵抗训练,散步,和瑜伽被发现是有效的剂量范围为820~1000METs-min/周，520~1000METs-min/周,650~1000METs-min/周,680~1000METs-min/周,分别。同时,我们发现当年龄超过81岁时，即使参加锻炼，它没有达到减轻老年人抑郁症状的效果。
结论：结论：包括散步,AE,瑜伽,气功,RT,TC,有效缓解老年人的抑郁症状。此外，我们确定了各种运动类型的统计学和临床意义的阈值剂量.早期开始锻炼是有益的，但是从80岁开始，它的功效就减弱了，超过81岁，运动不再显着缓解抑郁症状。
方法：本系统综述和网络荟萃分析包括搜索PubMed，Medline,Embase,PsycINFO,科克伦图书馆,和WebofScience对从开始到2023年7月15日有抑郁症状的老年人进行运动的随机对照试验。综合数据提取覆盖剂量，治疗方案，人口统计学和研究持续时间。剂量指标，包括MET-分钟/周，与最小临床重要性差异(MCID)相关进行了审查。
结果：共纳入47项研究，涉及2895名参与者和7种运动。不考虑剂量,我们的网络荟萃分析结果表明，步行是最有效的缓解老年人的抑郁症，除了有氧运动（AE），瑜伽,气功,阻力训练(RT),太极拳（TC），同样有效。然而,剂量-反应分析的结果发现,有氧运动在1000METs-min/周的剂量下最有效.值得注意的是，在非常低的剂量下，步行对缓解老年人的抑郁症状非常有效。就临床效益而言，我们发现600~970METs-min/周的总运动剂量是临床有效的.考虑到运动的具体类型，有氧运动,抵抗训练,散步,和瑜伽被发现是有效的剂量范围为820~1000METs-min/周，520~1000METs-min/周,650~1000METs-min/周,680~1000METs-min/周,分别。同时,我们发现当年龄超过81岁时，即使参加锻炼，它没有达到减轻老年人抑郁症状的效果。
结论：结论：包括散步,AE,瑜伽,气功,RT,TC,有效缓解老年人的抑郁症状。此外，我们确定了各种运动类型的统计学和临床意义的阈值剂量.早期开始锻炼是有益的，但是从80岁开始，它的功效就减弱了，超过81岁，运动不再显着缓解抑郁症状。
