Psychotherapeutic Interventions for Depressive Symptoms in Community-Dwelling Older Adults: A Systematic Review with Meta-Analysis

Abstract

The global ageing population faces rising depression rates due to social, economic, and health changes. Depression in older adults, often linked to isolation and health issues, requires comprehensive care. Psychotherapeutic interventions could be effective in reducing symptoms, offering personalized and holistic support. Particularly low-threshold interventions, such as those offered in community-dwelling older adults, which older adults can easily access and which may reduce stigma, promise to close the treatment gap. This review examines community-based psychotherapeutic interventions for older adults with depression. Methods: This review investigates psychotherapeutic interventions for reducing depressive symptoms in older adults in a community setting. RCTs were assessed using Joanna Briggs Institute tools. The following databases were searched: CINAHL Plus with Full Text, MedicLatina, MEDLINE with Full Text, and the Psychology and Behavioral Sciences Collection. Results: A meta-analysis of 13 studies with 1528 participants showed a medium, significant pooled effect size at post-intervention (Hedges’ g = −0.36, p < 0.001) and substantial heterogeneity. Follow-up analysis of studies indicated a small, non-significant effect (Hedges’ g = −0.17, p = 0.27). Group interventions, particularly the “reminiscence protocol”, had the largest significant effect. Discussion: This systematic review and meta-analysis found that in community-dwelling older adults’ group psychotherapeutic interventions, particularly the “reminiscence protocol” and “modified behavioral activation treatment” are most effective for reducing depressive symptoms. Individual psychotherapeutic interventions like “prevention of suicide in primary care elderly” and “behavioral activation” also show effectiveness, with group psychotherapeutic interventions being generally more effective than when these treatments are offered in individual psychotherapeutic interventions. Conclusion: Group and individual psychotherapeutic interventions reduce depressive symptoms in community-dwelling older adults, with group psychotherapeutic interventions being more effective.