Objectives We assessed the effects of different exercise modalities and doses on depression levels in older adults. Methods Systematic searches of the PubMed, Web of Science, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus databases were conducted from the start of database construction until December 2023. Studies were included if they were randomised controlled trials (RCTs) of exercise interventions in older adults. Pairwise, network and dose-network meta-analyses were conducted using random-effects models for the outcome of depression in older adults. Results A total of 80 RCTs with 5536 participants were included in this study. Network meta-analyses showed that resistance exercise [standardized mean difference (SMD) = − 0.68, 95% confidence interval (CI): − 0.90, − 0.46] and mind–body exercise (MBE; SMD = − 0.54, 95% CI: − 0.72, − 0.37) were the most effective forms of exercise for improving depression in older adults, followed by aerobic exercise (SMD = − 0.31, 95% CI: − 0.50, − 0.13) and mixed exercise (SMD = − 0.23, 95% CI: − 44, − 0.01). In addition, a U-shaped dose–response relationship was found between overall exercise dose and depression levels in older adults, and a significant response was seen after 390 metabolic equivalent (MET)-min/week. Conclusions Our study determined the effectiveness of different exercises in improving levels of older adults and found that resistance exercise and MBE were more effective adjunctive treatments. By providing the most effective treatments, older adults can reap the benefits of improving depression in older adults at doses lower than the World Health Organization guidelines.

中文翻译：

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各种运动类型和剂量对老年人抑郁症的疗效比较：配对、网络和剂量反应荟萃分析的系统评价


目的 我们评估了不同运动方式和剂量对老年人抑郁水平的影响。方法 从数据库建设开始到 2023 年 12 月，对 PubMed 、 Web of Science、 Embase、 PsycINFO、 护理和相关健康文献累积索引 （CINAHL） 和 Scopus 数据库进行了系统检索。如果研究是老年人运动干预的随机对照试验 （RCT），则纳入这些研究。使用随机效应模型对老年人抑郁症的结果进行成对、网络和剂量网络荟萃分析。结果 本研究共纳入 80 篇 RCT，涉及 5536 名参与者。网络荟萃分析显示，阻力运动 [标准化平均差 （SMD） = − 0.68,95% 置信区间 （CI）：− 0.90，− 0.46] 和身心运动 （MBE;SMD = − 0.54， 95% CI： − 0.72， − 0.37） 是改善老年人抑郁症的最有效运动形式，其次是有氧运动 （SMD = − 0.31， 95% CI： − 0.50， − 0.13） 和混合运动 （SMD = − 0.23， 95% CI： − 44， − 0.01）。此外，在老年人的整体运动剂量和抑郁水平之间发现 U 形剂量-反应关系，并且在 390 代谢当量 （MET） -min/week 后出现显着反应。结论 我们的研究确定了不同运动在提高老年人水平方面的有效性，发现阻力运动和 MBE 是更有效的辅助治疗。通过提供最有效的治疗方法，老年人可以在低于世界卫生组织指南的剂量下获得改善老年人抑郁症的好处。