SYSTEMATIC REVIEW article
Front. Psychiatry
Sec. Psychological Therapy and Psychosomatics
Single non-pharmacological intervention of depression in the elderly with cognitive dysfunction:a systematic review and network meta-analysis
Provisionally accepted
- 1KIANG WU NURSING COLLEGE OF MACAU, Macau, Macao, SAR China
- 2Department of Nursing, Hunan Normal University, Changsha, Hunan Province, China
- 3Nursing & Health Education Research Centre, Kiang Wu Nursing College of Macau, Macau SAR;, Macao, Macao, SAR China
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Purpose: This study was conducted to appraise the comparative efficacy of single non-pharmacological methods on depression for cognitive dysfunction patients utilizing network meta-analysis (NMA) and resolve ambiguities in existing literature to help practitioners accurately determine the efficacy and formulate the optimal therapeutic models. Design: Systematic Review and Network meta-analysis. Methods: PubMed, Embase, Cochrane, and Web of Science were searched. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. Two investigators independently undertook data extraction and quality evaluation. Result: Overall, 26 articles incorporating 10 single non-pharmacological interventions were identified. Compared to control, GAME (SMD = −1.00, 95% CrI = −1.70 to −0.39) and mindfulness (SMD = −0.58, 95% CrI = −0.99 to −0.17) significantly alleviated depressive symptoms. RTBC (SMD = −0.49, 95% CrI = −0.88 to −0.09) and MUSIC (SMD = −0.47, 95% CrI = −0.84 to −0.08) showed moderate effects, and PE (SMD = −0.37, 95% CrI = −0.67 to −0.09) showed small effects. Conclusion: In this network meta-analysis, we synthesized 26 trials to quantify the isolated impact of 10 single non-pharmacological interventions on depressive symptoms. Against usual care (basic medical support, sham stimulation, or wait-list), GAME and mindfulness produced the largest and statistically credible reductions. Reminiscence-therapy-based care (RTBC) and music therapy (MUSIC) generated medium benefits, whereas physical exercise (PE) yielded a small yet significant effect. These findings were robust across both direct and indirect evidence, underscoring GAME and mindfulness as the most effective stand-alone non-pharmacological options for mitigating depression.
Keywords: cognitive dysfunction, Depression, Aging, Non-pharmacologicalintervention, Network meta-analysis
Received: 09 Apr 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Tan, Li, Su, Liu and Chuang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lihua Liu, llh1395@163.com
Yao-Chen Chuang, jasonchuang@kwnc.edu.mo
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.