title: Complementary and alternative treatments for late-life depression, anxiety, and sleep disturbance: a review of randomized controlled trials.
abstract: OBJECTIVE
  We reviewed randomized controlled trials of complementary and alternative medicine (CAM) treatments for depression, anxiety, and sleep disturbance in nondemented older adults.
  
  
  METHODS
  We searched PubMed (1966-September 2006) and PsycINFO (1984-September 2006) databases using combinations of terms including depression, anxiety, and sleep; older adult/elderly; randomized controlled trial; and a list of 56 terms related to CAM.
  
  
  METHODS
  Of the 855 studies identified by database searches, 29 met our inclusion criteria: sample size >or= 30, treatment duration >or= 2 weeks, and publication in English. Four additional articles from manual bibliography searches met inclusion criteria, totaling 33 studies.
  
  
  METHODS
  We reviewed identified articles for methodological quality using a modified Scale for Assessing Scientific Quality of Investigations (SASQI). We categorized a study as positive if the CAM therapy proved significantly more effective than an inactive control (or as effective as active control) on at least 1 primary psychological outcome. Positive and negative studies were compared on the following characteristics: CAM treatment category, symptom(s) assessed, country where the study was conducted, sample size, treatment duration, and mean sample age.
  
  
  RESULTS
  67% of the 33 studies reviewed were positive. Positive studies had lower SASQI scores for methodology than negative studies. Mind-body and body-based therapies had somewhat higher rates of positive results than energy- or biologically-based therapies.
  
  
  CONCLUSIONS
  Most studies had substantial methodological limitations. A few well-conducted studies suggested therapeutic potential for certain CAM interventions in older adults (e.g., mind-body interventions for sleep disturbances and acupressure for sleep and anxiety). More rigorous research is needed, and suggestions for future research are summarized.
authors.affiliation: Division of Geriatric Psychiatry, Department of Psychiatry, University of California, San Diego, USA. tmeeks@ucsd.edu
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Meeks
authors.forename: Julie L
authors.initials: JL
authors.lastname: Wetherell
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
authors.forename: Laura S
authors.initials: LS
authors.lastname: Redwine
authors.forename: Dilip V
authors.initials: DV
authors.lastname: Jeste
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D000529:Complementary Therapies / Q000379:methods*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*