School of Design, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China,
School of System Design and Intelligent Manufacturing, Southern University of Science and Technology, Shenzhen, China.
Gerontology. 2024;70(9):991-1012. doi: 10.1159/000539404. Epub 2024 Jun 10.
Anxiety and depression are prevalent among older adults, and digital interactive interventions have shown promise in promoting their mental well-being. However, limited research has explored the effects of different types of digital interactive interventions across various devices on anxiety and depression in older adults with different health conditions.
A systematic literature review and meta-analysis were conducted using seven selected databases to identify relevant studies up to July 19, 2023. Two reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the Cochrane risk-of-bias tool. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) using a random-effects model.
A total of 20 randomized control trails involving 1,309 older adults fulfilled inclusion criteria. The meta-analysis results demonstrates that the digital interactive intervention technologies had a significance on depression (SMD = -0.656 s, 95% confidence interval [CI] = -0.992 to -0.380, p < 0.001) and anxiety (SMD = -0.381 s, 95% CI = -0.517 to -0.245, p < 0.001). Physical interactive interventions demonstrated a significant effect on depression and anxiety (SMD = -0.711 s, 95% CI = -1.102 to -0.319, p < 0.001) and (SMD = -0.573 s, 95% CI = -0.910 to -0.236, p = 0.001). Similarly, immersive interactive interventions also showed a significant effect on depression and anxiety (SMD = -0.699 s, 95% CI = -1.026 to -0.373, p < 0.001) and (SMD = -0.343 s, 95% CI = -0.493 to -0.194, p < 0.001). Additionally, in the internal medicine group, significant intervention effects were observed for depression (SMD = -0.388, 95% CI = -0.630 to -0.145, p = 0.002) and anxiety (SMD = -0.325, 95% CI = -0.481 to -0.169, p < 0.001). Similarly, in the neurocognitive disorders group, significant intervention effects were found for depression (SMD = -0.702, 95% CI = -0.991 to -0.413, p < 0.001) and anxiety (SMD = -0.790, 95% CI = -1.237 to -0.342, p = 0.001).
The results indicated that various digital interactive devices, including physical and immersive interactive devices, have a positive impact on depression and anxiety among older adults. However, mobile games were not effective in addressing depression. Digital interactive technologies did not significantly influence anxiety intervention, except for elderly individuals undergoing surgical procedures. Nevertheless, these interventions effectively addressed depression and anxiety in older individuals with neurocognitive disorders, internal medical issues, and those without health issues.
焦虑和抑郁在老年人中很常见，数字互动干预在促进他们的心理健康方面显示出了潜力。然而，有限的研究探讨了不同类型的数字互动干预在不同设备上对不同健康状况的老年人的焦虑和抑郁的影响。
使用七个选定的数据库进行了系统的文献综述和荟萃分析，以确定截至 2023 年 7 月 19 日的相关研究。两名审查员独立进行了研究选择、数据提取和质量评估。使用 Cochrane 偏倚风险工具评估纳入研究的偏倚风险。对于荟萃分析，使用随机效应模型计算标准化均数差（SMD）作为效应量。
共有 20 项随机对照试验纳入了 1309 名老年人，符合纳入标准。荟萃分析结果表明，数字互动干预技术对抑郁（SMD=-0.656 s，95%置信区间[CI]=-0.992 至-0.380，p<0.001）和焦虑（SMD=-0.381 s，95%CI=-0.517 至-0.245，p<0.001）有显著影响。物理互动干预对抑郁和焦虑（SMD=-0.711 s，95%CI=-1.102 至-0.319，p<0.001）和（SMD=-0.573 s，95%CI=-0.910 至-0.236，p=0.001）均有显著影响。同样，沉浸式互动干预对抑郁和焦虑（SMD=-0.699 s，95%CI=-1.026 至-0.373，p<0.001）和（SMD=-0.343 s，95%CI=-0.493 至-0.194，p<0.001）也有显著影响。此外，在内科组中，抑郁（SMD=-0.388，95%CI=-0.630 至-0.145，p=0.002）和焦虑（SMD=-0.325，95%CI=-0.481 至-0.169，p<0.001）的干预效果显著。同样，在神经认知障碍组中，抑郁（SMD=-0.702，95%CI=-0.991 至-0.413，p<0.001）和焦虑（SMD=-0.790，95%CI=-1.237 至-0.342，p=0.001）的干预效果显著。
结果表明，各种数字互动设备，包括物理和沉浸式互动设备，对老年人的抑郁和焦虑有积极影响。然而，移动游戏对治疗抑郁没有效果。数字互动技术对焦虑的干预没有显著影响，除了接受手术的老年患者。然而，这些干预措施在患有神经认知障碍、内科疾病和无健康问题的老年人中有效地治疗了抑郁和焦虑。
