以系統性文獻回顧及統合分析法探討運動對於老人憂鬱的療效

Effects of exercise on depression in older people: a systematic review and meta-analysis

目標：以系統性文獻回顧與統合分析法，整合及探討運動對於老人憂鬱的療效。方法：搜尋的資料庫包含：2004年到2019年間發表於Pubmed、CINAHL、Cochrane Library、華藝線上圖書館、台灣期刊論文索引系統、台灣博碩士論文知識加值系統等電子資料庫。證據等級採用Melnyk和Fineout—Overholt提出介入性研究的證據等級。擷取後之資料採用RevMan5.3軟體進行統合分析（Meta—Analysis），以檢視運動介入對老人憂鬱之療效。結果：納入結果分析的文章有13篇，共有1,477位受試者（實驗組720&對照組757人），95％CI【—0.45,—0.10】，Z=3.14，p=0.002，顯示綜合效果量為—0.27，表示運動介入可改善老人的憂鬱，但成效偏低。在次群體分析部份呈現：運動介入時間為「至少24週」、「每週運動兩次或三次」且對象為「社區老人」，可有效緩解憂鬱程度。結論：老人接受運動治療，可以改善其憂鬱。建議社區老人之運動設計，運動時間可設計為「至少24週」、且「每週運動兩次或三次」，以利緩解其憂鬱|未來希望納入更多實證研究，以針對介入運動種類、運動介入時間、每週介入的次數及受試者特質（種族、年齡、不同憂鬱程度個案）等因素，進行更明確的分析與討論。（台灣衛誌2020|39(3)：278—291）
Objectives: To integrate and explore the effects of exercise on depression in older people by a systematic literature review and meta-analysis. Methods: The electronic databases PubMed, CINAHL, Cochrane Library, Index to Taiwan Periodical Literature System, and National Digital Library of Thesis and Dissertations were searched for articles published between 2004 and 2019 in Taiwan. This study used the level of evidence outlined in the article by Melnyk and FineoutOverholt (2005) for the interventional study. A meta-analysis was applied using the RevMan 5.3 to examine the effects of the exercise interventions on depression in older people. Results: This study included 13 articles in the analysis. In total, 1477 participants (exercise: 720| control: 757, 95% confidence interval [−0.45, −0.10], Z = 3.14, p = 0.002) showed a combined effect of −0.27, indicating that exercise intervention could improve the degree of depression in older people. According to the subgroup analysis, the intervention time is ''two or three times a week for at least 24 weeks'', and the participant belongs to the ''elderly community,'' which can effectively alleviate the degree of depression. Conclusions: Exercise can improve the degree of depression in older people. The recommended exercise protocol of older people in the community is that it should last for ''at least 24 weeks'', and include ''exercise twice or three times a week'' to alleviate their depression. More empirical studies are suggested in the future to provide a clearer analysis and discuss the factors of types of activity interventions, duration of exercise interventions, number of weekly interventions, and demographic characteristics (race, age, and degrees of depression). (Taiwan J Public Health. 2020|39(3):278-291)