Soong Rou Yi, Low Chen Ee, Ong Vanessa, Sim Isaac, Lee Charmaine, Lee Fattah, Chew Lucas, Yau Chun En, Lee Ainsley Ryan Yan Bin, Chen Matthew Zhixuan
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore.
JAMA Netw Open. 2025 Feb 3;8(2):e2457859. doi: 10.1001/jamanetworkopen.2024.57859.
Cancer and its treatment negatively impact the mental health of older adults. The potential of exercise interventions as a complementary treatment to alleviate the psychological impacts of cancer is promising, but there are gaps in the current literature.
To determine if exercise interventions are associated with improvements in psychological outcomes among older adults with cancer.
PubMed, Embase, PsycINFO, and Cochrane databases were searched from database inception to November 5, 2024. Search terms used were geriatrics, cancer, depression, anxiety, quality of life, and exercise interventions.
English-language randomized clinical trials (RCTs) that analyzed the association of various exercise interventions with at least 1 of 3 psychological outcomes (depression, anxiety, or health-related quality-of-life [HRQOL]) were included. The control groups were given usual care. Studies were included if the mean age of participants was older than 60 years and had participants with a diagnosis of any cancer regardless of comorbidities.
Studies were screened, and data were extracted by 2 independent authors. Random-effects meta-analyses and meta-regressions were used for analysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed.
The primary outcomes were depression, anxiety, and HRQOL. Standardized mean difference (SMD) was used to quantify the association of exercise interventions with outcomes.
A total of 27 RCTs with 1929 participants were included. Meta-analyses observed an association of exercise with a significant reduction in levels of depression (SMD = -0.53; 95% CI, -0.79 to -0.28) and anxiety (SMD = -0.39; 95% CI, -0.66 to -0.12) and improvements in overall HRQOL (SMD = 0.63; 95% CI, 0.10 to 1.17). Subgroup analyses revealed that mind-body exercise interventions were significantly associated with improved depression (SMD = -0.89; 95% CI, -1.51 to -0.27) and anxiety levels (SMD = -0.77; 95% CI, -1.54 to -0.01) compared with conventional exercise interventions.
In this systematic review and meta-analysis of 27 RCTs, exercise interventions were found to be associated with significantly reduced levels of depression and anxiety and significantly improved HRQOL in older adults with cancer. These findings suggest that health care professionals and policymakers should focus more on implementing exercise interventions to improve mental health outcomes in this vulnerable population.
癌症及其治疗会对老年人的心理健康产生负面影响。运动干预作为一种辅助治疗手段来减轻癌症对心理的影响，其潜力很有前景，但目前的文献存在空白。
确定运动干预是否与改善老年癌症患者的心理结局相关。
检索了PubMed、Embase、PsycINFO和Cochrane数据库，检索时间从数据库建立至2024年11月5日。使用的检索词包括老年医学、癌症、抑郁、焦虑、生活质量和运动干预。
纳入分析各种运动干预与3种心理结局（抑郁、焦虑或健康相关生活质量[HRQOL]）中至少1种之间关联的英文随机临床试验（RCT）。对照组接受常规护理。如果参与者的平均年龄超过60岁且患有任何癌症（无论有无合并症），则纳入研究。
由2名独立作者对研究进行筛选和数据提取。采用随机效应荟萃分析和荟萃回归进行分析。遵循系统评价和荟萃分析的首选报告项目指南。
主要结局为抑郁、焦虑和HRQOL。采用标准化均数差（SMD）来量化运动干预与结局之间的关联。
共纳入27项RCT，1929名参与者。荟萃分析观察到运动与抑郁水平显著降低（SMD = -0.53；95%CI，-0.79至-0.28）、焦虑水平显著降低（SMD = -0.39；95%CI，-0.66至-0.12）以及总体HRQOL改善（SMD = 0.63；95%CI，0.10至1.17）相关。亚组分析显示，与传统运动干预相比，身心运动干预与抑郁改善（SMD = -0.89；95%CI，-1.51至-0.27）和焦虑水平降低（SMD = -0.77；95%CI，-1.54至-0.01）显著相关。
在这项对27项RCT的系统评价和荟萃分析中，发现运动干预与老年癌症患者抑郁和焦虑水平显著降低以及HRQOL显著改善相关。这些发现表明，医疗保健专业人员和政策制定者应更加关注实施运动干预，以改善这一弱势群体的心理健康结局。
