Frontiers in psychology · 2026
Effects of mind-body exercises on depressive symptoms in older adults: a comprehensive umbrella review of the evidence.
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Li Fangbo, Li Qingfang, Huang Jiafu, Li Xuecheng, Lu Zuosheng
Аннотация
BACKGROUND: Depression is common in older adults, often with suboptimal pharmacological responses. Mind-body exercises (MBEs) like Tai Chi, Yoga, and Qigong have emerged as potentially beneficial non-pharmacological interventions. However, existing systematic reviews report heterogeneous findings, necessitating a comprehensive synthesis of the available evidence.
METHODS: We systematically searched PubMed, Cochrane Library, Web of Science, and ScienceDirect to August 2025, following PRISMA and PRIOR guidelines. Systematic reviews and meta-analyses examining MBEs' effects on depressive symptoms in adults ≥60 years were included. The Corrected Covered Area (CCA) assessed overlap between reviews. Effect sizes were synthesized using random-effects modeling. Quality was assessed via AMSTAR-2 and GRADE.
RESULTS: Twenty-five reviews (>20,000 participants) were included, with moderate overlap (CCA = 6.98%). The synthesized evidence suggested moderate reductions in depressive symptoms (pooled SMD = -0.51, 95% CI: -0.66 to -0.35, p < 0.0001). Subgroup analyses showed larger effect sizes for Qigong (SMD = -0.49) vs. Yoga (SMD = -0.45) and Tai Chi (SMD = -0.34). However, substantial heterogeneity was observed (I 2 = 90.89%). Sensitivity analyses confirmed robustness. Trim-and-fill adjustment suggested potential publication bias (adjusted SMD = -0.40).
CONCLUSION: This umbrella meta-analysis provides moderate-certainty evidence that MBEs, particularly Qigong, may be associated with reductions in depressive symptoms in older adults, though the substantial heterogeneity (I 2 = 90.89%) across included reviews indicates that pooled estimates should be interpreted as reflecting a general directional trend rather than definitive effect sizes. A quality-stratified sensitivity analysis restricted to High Confidence reviews yielded a stronger and homogeneous effect (SMD = -0.62, I 2 = 0.0%). However, the predominance of lower-quality reviews and evidence of publication bias necessitate cautious interpretation. These findings provide a directional evidence synthesis to inform future high-quality research rather than definitive clinical recommendations.
SYSTEMATIC TRIAL REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251131812, Identifer [PROSPERO 2025 CRD420251131812].
METHODS: We systematically searched PubMed, Cochrane Library, Web of Science, and ScienceDirect to August 2025, following PRISMA and PRIOR guidelines. Systematic reviews and meta-analyses examining MBEs' effects on depressive symptoms in adults ≥60 years were included. The Corrected Covered Area (CCA) assessed overlap between reviews. Effect sizes were synthesized using random-effects modeling. Quality was assessed via AMSTAR-2 and GRADE.
RESULTS: Twenty-five reviews (>20,000 participants) were included, with moderate overlap (CCA = 6.98%). The synthesized evidence suggested moderate reductions in depressive symptoms (pooled SMD = -0.51, 95% CI: -0.66 to -0.35, p < 0.0001). Subgroup analyses showed larger effect sizes for Qigong (SMD = -0.49) vs. Yoga (SMD = -0.45) and Tai Chi (SMD = -0.34). However, substantial heterogeneity was observed (I 2 = 90.89%). Sensitivity analyses confirmed robustness. Trim-and-fill adjustment suggested potential publication bias (adjusted SMD = -0.40).
CONCLUSION: This umbrella meta-analysis provides moderate-certainty evidence that MBEs, particularly Qigong, may be associated with reductions in depressive symptoms in older adults, though the substantial heterogeneity (I 2 = 90.89%) across included reviews indicates that pooled estimates should be interpreted as reflecting a general directional trend rather than definitive effect sizes. A quality-stratified sensitivity analysis restricted to High Confidence reviews yielded a stronger and homogeneous effect (SMD = -0.62, I 2 = 0.0%). However, the predominance of lower-quality reviews and evidence of publication bias necessitate cautious interpretation. These findings provide a directional evidence synthesis to inform future high-quality research rather than definitive clinical recommendations.
SYSTEMATIC TRIAL REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251131812, Identifer [PROSPERO 2025 CRD420251131812].