Effectiveness of Acceptance and Commitment Therapy on Reducing Depression and Anxiety in Older Adults: A Systematic Review and Meta-Analysis.

Abstract

To assess the effectiveness of acceptance and commitment therapy (ACT) in reducing depressive and anxiety symptoms in older adults. A systematic review and meta-analysis. Nine databases were searched for publications up to 2 April 2024, using combinations of search terms related to depression, anxiety, ACT, older adults and randomised controlled trials (RCTs). Two researchers were selected according to inclusion and exclusion criteria, data extraction and methodological quality evaluation, and Stata 16.0 software was used for meta-analysis. Seven articles were included in a systematic review and six were in a meta-analysis. The results indicated that, compared to the control group, ACT had a small but significant effect in reducing depressive symptom (SMD = -0.22, 95% CI, -0.38 to -0.06, p < 0.001; 576 older adults; low-quality evidence), while it showed a small, non-significant effect on reducing anxiety symptoms (SMD = -0.29, 95% CI, -0.73 to 0.15, p = 0.194; 576 older adults; very low-quality evidence). Subgroup analysis based on the different control conditions may have some enlightenment on the sources of heterogeneity. ACT can be an important component of future psychotherapy for older adults, as it may alleviate depressive symptoms. However, high-quality studies with large samples, multiple centres and long follow-up durations should be performed to further reliably assess the treatment effects of depressive symptoms and explore potential benefits for anxiety symptoms.