The Role of Psychological Interventions in the Mental Health and Quality of Life of Older Adults: A Systematic Review with Meta-Analysis of Mindfulness, Cognitive Behavioral Therapy, and Reminiscence-Based Approaches

TL;DR

This study finds that psychological interventions like CBT and mindfulness can improve mental health and reduce stress in older adults, though effects vary for anxiety and quality of life.

Contribution

The paper provides a meta-analysis of recent randomized trials on psychological interventions for older adults, revealing consistent benefits for emotional symptoms.

Findings

Psychological interventions significantly reduce emotional symptoms like depression and stress in older adults.

Subgroup analyses show a moderate effect on depression and a large effect on perceived stress.

Effects on anxiety and loneliness are smaller and more variable, with no significant impact on mindfulness or quality of life.

Abstract

Psychological problems such as depression, anxiety, stress, loneliness, and reduced quality of life are prevalent in older adults, yet the effectiveness of psychological interventions remains heterogeneous. This systematic review with meta-analysis evaluated the impact of psychological and psychoeducational interventions on emotional symptoms and quality-of-life outcomes in adults aged 60 years and older. Following PRISMA 2020 guidelines, a comprehensive search was conducted in PubMed, Scopus, CINAHL, and Web of Science. Randomized controlled trials published in the last five years were included if they assessed interventions such as mindfulness, cognitive behavioral therapy, reminiscence therapy, or behavioral activation. Twenty-eight trials were included in the qualitative synthesis and twenty-two in the meta-analysis. Standardized mean differences (Hedges’ g) were pooled under fixed- and random-effects models. Heterogeneity, subgroup analyses, and publication bias were examined using Q, I2, Begg–Mazumdar, Egger, and Trim-and-Fill methods. The global meta-analysis showed a moderate and significant favorable effect of psychological interventions on emotional symptoms under the random-effects model (SMD = −0.623, 95% CI −0.888 to −0.359; p < 0.001), where negative values indicate reductions in symptom severity. Subgroup analyses revealed a moderate effect on depressive symptoms, which remained significant after adjustment for publication bias, and a large effect on perceived stress (SMD = 0.581; p < 0.001); for stress outcomes, positive SMDs indicate reductions in stress (i.e., improvement) after aligning scale directionality. Anxiety showed a significant effect only under the fixed-effects model, while loneliness showed a small but significant effect (SMD = −0.110; p = 0.018). Mindfulness-specific outcomes and quality of life did not show significant pooled effects. No substantial publication bias was detected. Psychological interventions significantly improve emotional well-being in older adults, particularly by reducing depression and stress. Effects on anxiety, loneliness, mindfulness, and quality of life are more variable, emphasizing the need for methodological consistency and longer follow-up in future studies.

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