Evaluating the effects of physical activity and antidepressive agents on depressive symptoms in older adults: a meta-analysis of existing evidence.
Level 1 - systematic review of randomized trials
Meta-analysis synthesizing 22 intervention studies.
PubMed 41239235 · doi:10.1186/s12877-025-06626-w
What was done
Searched PubMed, Web of Science, and Cochrane Library databases for published English-language studies evaluating the effects of physical activity or antidepressant agents on depressive symptoms in adults aged 65 and older. The authors quantitatively synthesized 22 target articles using random-effects meta-analysis in RevMan 5.3 to calculate standardized mean differences (SMD) and compare the two intervention modalities.
What was found
Both physical activity and antidepressant medications significantly reduced depressive symptoms: - Physical activity: SMD = -0.60 (95% CI [-0.77, -0.43], Z = 7.05, p < 0.00001) - Antidepressants: SMD = -0.30 (95% CI [-0.44, -0.16], Z = 4.15, p < 0.0001) - Overall pooled effect: SMD = -0.46 (95% CI [-0.59, -0.33], Z = 6.87, p < 0.00001) There was a statistically significant difference between the effect sizes of the two interventions favoring physical activity (Chi2 = 7.20, df = 1, p = 0.007).
Why it matters
Physical activity is an effective intervention for geriatric depression that may yield greater symptom reduction than standard antidepressant pharmacotherapy.
Limits
The abstract does not report the total participant sample size, the specific study designs of the included literature, or the specific drug classes and exercise types evaluated. The comparison between physical activity and antidepressants appears to be an indirect subgroup comparison across separate study arms rather than a synthesis of direct head-to-head randomized trials. Inclusion was restricted to English-language publications.