Evaluating the effects of physical activity and antidepressive agents on depressive symptoms in older adults: a meta-analysis of existing evidence.

Abstract

<h4>Background</h4>Although a wide range of treatments for depression are currently available, the condition continues to pose a substantial threat to the physical health of older adults. In recent years, physical activity has attracted increasing attention for its beneficial effects in alleviating depressive symptoms, compared to antidepressant medication.<h4>Objective</h4>This meta-analysis aimed to estimate and compare the standardized effects of physical activity and antidepressive agents in alleviating depressive symptoms among older adults aged 65 and above. By quantitatively synthesizing results from multiple independent studies, the goal is to derive a more precise and generalizable estimate of intervention efficacy, thereby informing evidence-based clinical practice in geriatric mental health.<h4>Methods</h4>Searched the PubMed, Web of Science, and Cochrane Library databases for published English literature and screened 22 target articles with depression symptoms as outcome indicators. Meta-analysis statistics were conducted using Revman 5.3 to calculate effect sizes and standard mean differences reflecting the magnitude of the effect indicators.<h4>Results</h4>The meta-analysis, conducted using a random-effects model, demonstrated that both physical activity (PA-SD) and antidepressive agents (AA-SD) significantly reduced depressive symptoms (DS) among older adults. The effect size for PA-SD reached a statistically significant moderate level (SMD = - 0.60, 95% CI [-0.77, - 0.43], Z = 7.05, p < 0.00001), while that for AA-SD reached a statistically significant small level (SMD = - 0.30, 95% CI [-0.44, - 0.16], Z = 4.15, p < 0.0001). The overall pooled effect size across all included studies was SMD = - 0.46 (95% CI [-0.59, - 0.33], Z = 6.87, p < 0.00001). A statistically significant difference in effect sizes was observed between the two intervention types (Chi² = 7.20, df = 1, p = 0.007).<h4>Conclusions</h4>Physical activity and antidepressive agents can both alleviate depression symptoms in older adults, but there are significant differences in impact methods or mechanisms between the two.<h4>Trial registration</h4>This study has been registered in PROSPERO (ID: CRD420251008013).