Effects of a mind-body exercise intervention on anxiety, depression and quality of life in elderly patients with chronic obstructive pulmonary disease: A systematic evaluation and META analysis.

BACKGROUND

Elderly patients with Chronic Obstructive Pulmonary Disease (COPD) commonly suffer from anxiety, depression, and impaired health-related quality of life (HRQOL). This review evaluated the effects of mind-body exercises on these outcomes and exercise tolerance in COPD patients aged ≥ 60 years.

METHODS

Following PRISMA guidelines, we systematically searched PubMed, Embase, PsycINFO, Cochrane Library, and Web of Science (inception-January 2025) for randomized controlled trials (RCTs) comparing mind-body exercise versus usual care. Outcomes were anxiety, depression, HRQOL (St. George's Respiratory Questionnaire or Chronic Respiratory Questionnaire), and exercise tolerance (6-minute walk test). Meta-analyses used random-effects models, reporting Standardized Mean Differences (SMDs) or Mean Differences (MDs) with 95 % confidence intervals (CIs). Evidence certainty was assessed (GRADE framework). Seventeen RCTs were included.

RESULTS

Mind-body exercise reduced anxiety (SMD = -0.59, 95 % CI: -0.84 to -0.34; high certainty) and depression (SMD = -0.34, 95 % CI: -0.54 to -0.14; high certainty). HRQOL improved significantly (SMD = -0.79, 95 % CI: -1.14 to -0.44; low certainty), with exploratory findings showing greater improvement in Southeast Asian patients (SMD = -3.41). Exercise tolerance increased (MD = 44.23 m, 95 % CI: 26.12-62.34), exceeding minimal clinically important differences. Intervention duration for depression was a key moderator, with greater benefits in patients with interventions lasting ≥ 3080 min.

CONCLUSION

Mind-body exercise reduces anxiety and depression, improves health-related quality of life, and increases exercise tolerance in elderly patients with COPD. For anxiety and depression, benefits are significantly enhanced with intervention durations ≥ 3080 minutes. Incorporating mind-body exercise into comprehensive COPD management for older adults is recommended.