Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Int J Geriatr Psychiatry. 2023 May;38(5):e5920. doi: 10.1002/gps.5920.
Anxiety and depression are prevalent in the elderly and lead to loss of functionality and increased mortality. Although the use of antidepressants and face-to-face psychotherapies are indicated, the current context of telemedicine provides an alternative, with the advantage of facilitating access to care. The study aimed to evaluate the efficacy of telemedicine interventions to reduce anxiety and depression in the elderly through a systematic review with meta-analysis.
The systematic review, through a search in 7 databases, included studies that evaluated the use of telemedicine interventions for depressive or anxious symptoms in the elderly, compared with usual care or waiting list or with another telemedicine intervention. Quantitative assessment was performed through meta-analysis.
A total of 31 articles identified in the search met the eligibility criteria and four were included for meta-analysis. Studies showed that telemedicine interventions are feasible and several studies demonstrated significant improvement in depressive or anxiety symptoms. Four studies evaluated the efficacy of internet-delivered cognitive behavioral therapy for depression and anxiety in older adults, compared with a waitlist, and found pooled effect sizes of -1.20 (95% CI -1.60 to -0.81) and -1.14 (95% CI -1.56 to -0.72), respectively, with low heterogeneity.
Telemedicine interventions can be an alternative for the treatment of mood and anxiety symptoms in the elderly. However, more studies are needed to prove their clinical effectiveness, especially in countries with lower incomes and diverse culture and education.
焦虑和抑郁在老年人中很常见，会导致功能丧失和死亡率增加。尽管使用抗抑郁药和面对面心理疗法是有指征的，但当前的远程医疗环境提供了一种替代方案，其优势在于便于获得治疗。本研究旨在通过系统评价和荟萃分析评估远程医疗干预措施在减轻老年人焦虑和抑郁方面的疗效。
通过在 7 个数据库中进行搜索，进行了系统评价，纳入了评估远程医疗干预措施用于治疗老年人抑郁或焦虑症状的研究，与常规护理或等待名单或另一种远程医疗干预措施进行比较。通过荟萃分析进行定量评估。
在搜索中总共确定了 31 篇符合资格标准的文章，其中 4 篇被纳入荟萃分析。研究表明，远程医疗干预措施是可行的，并且有几项研究表明抑郁或焦虑症状有显著改善。四项研究评估了互联网提供的认知行为疗法对老年抑郁和焦虑的疗效，与等待名单相比，发现合并效应量分别为-1.20（95%CI-1.60 至-0.81）和-1.14（95%CI-1.56 至-0.72），异质性较低。
远程医疗干预措施可能是治疗老年人情绪和焦虑症状的一种替代方法。然而，需要更多的研究来证明其临床疗效，特别是在收入较低、文化和教育多样化的国家。
