Effects of exercise on depressive symptoms among nursing home residents: a meta-analysis

Abstract

Objective

We examined the effects of exercise on depression in older adults living in nursing homes and explored the moderator effects of participants, methods, and intervention characteristics.

Methods

We searched 8 databases from inception to January 2020 without date restrictions. We retrieved primary studies measuring exercise with 60-year-olds with depression that were written in English. Two researchers independently coded each primary study and compared codes for discrepancies. They consulted a third researcher to come to consensus. We used random-effects model to compute effect sizes using Hedges’ g, a forest plot, and Q and I² statistics as measures of heterogeneity. We also examined moderator analyses.

Results

Twenty-one studies included 2,594 participants (81.8 ± 4.8 years old). Overall, exercise showed a small improvement in depression compared to controls (ES=.25; 95%CI 0.11, 0.38; p=.000). Interestingly, interventionists by physiotherapists had a smaller effect on depressive symptoms (.04) than other health interventionists (.37). As people aged, exercise was less effective in reducing depression (slope=-.03, Q_model=5.03, p=.025). Researchers who included a higher percentage of women in exercise showed less improvement of depression (slope=-.01, Q_model=8.60, p=.003). Also, when researchers used depression scales with higher reliability values, they measured higher levels of depression (slope = 5.48, Q_model=5.60, p=.018). No other quality indicators moderated the effects of exercise on depression.

Conclusion

Exercise significantly improved depressive symptoms among older adults in nursing homes. Exercise might be used as adjunct/alternative complementary treatment for improving depressive symptoms in older adults in nursing homes.

Keywords:

• Exercise
• depression
• older adults
• nursing homes
• meta-analysis

Acknowledgements

The authors acknowledge Mary M. Krieger, MLIS, RN for her expertise and valuable time helping with the search.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the China Scholarship Council under Grant [number 201908525077].