Efficacy of Mind-body Exercise to Reduce Sleep Disturbance and Depression Among Older Adults: A Systematic Review and Meta-analysis

Purpose: Mind-body exercise is a promising non-pharmacological approach for managing sleep disturbance and depression that are prevalent among older adults, but its efficacy remains inconclusive across the studies. This study aimed to systematically evaluate and quantify the overall effectiveness of mindbody exercises on sleep disturbance and depression in older adults. Methods: We searched eight databases to identify relevant articles from their inception to April 2024. Experimental studies that evaluate the effects of mind-body movement therapy on sleep disturbance and depression in older adults were included. The Cochrane Risk of Bias tool version 2.0 was used to appraise included studies. The pairwise meta-analysis was performed through the software Comprehensive MetaAnalysis Version 3.0. Moreover, subgroup analysis was utilized to understand the effect size on each form of mind-body exercise and to determine the source of heterogeneity. Results: A total of 27 studies were eligible and synthesized. The mind-body exercise appears statistically significant in reducing sleep disturbance (SMD = -0.60, 95% CI: 0.76 - 0.44) and depression (SMD = -0.56, 95% CI: 0.75 - 0.36) among older adults. Each form of mind-body exercise, including pilates, yoga, qigong, and tai-chi, effectively decreases sleep disturbance and depression, but there were no significant differences in the effects between these practices. Conclusion: The cumulative evidence concludes that older adults who participated in mind-body exercise programs showed potential improvements in sleep disturbance and depression. This finding may serve as evidence for professionals to use this approach as a non-pharmacological approach to help older adults in the community and long-term care facilities who are having sleep disturbance and depression. More clinical trials are needed for an in-depth meta-analysis that can rank and compare the efficacy of each mind-body exercise practice. (c) 2024 Korean Society of Nursing Science. Published by Elsevier BV. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).