title: Is exercise effective in promoting mental well-being in older age? A systematic review.
abstract: BACKGROUND
  Promoting the mental well-being of older people has been neglected.
  
  
  OBJECTIVE
  To examine the clinical and cost-effectiveness of exercise and physical activity interventions on mental well-being in people aged 65+.
  
  
  METHODS
  Systematic review, meta-analysis, economic model.
  
  
  METHODS
  Reports published in English, identified by searching 25 databases, 11 websites and references lists of systematic reviews. Eligible studies were those with a comparison or control group or offering qualitative evidence; exercise and physical activity interventions for people aged 65 and above living at home, in the community, in supported housing or in residential care homes; including outcome measures of mental well-being, not simply measures of depression or anxiety. Low-quality studies were excluded from the data synthesis.
  
  
  RESULTS
  An overall effect of exercise on mental well-being was found (standardised effect size = 0.27; CI = 0.14-0.40). The included interventions were designed for older people, targeted those who are sedentary and delivered in a community setting, primarily through a group-based approach led by trained leaders. As a minimum, the evidence would suggest two exercise sessions per week, each of 45 min duration. There is some indication that exercise can also improve the mental well-being of frail elders. Economic evidence indicated incremental cost-effectiveness ratios (compared with minimal intervention) of pound 7300 and pound 12,100 per quality adjusted life year gained for community-based walking and exercise programmes, respectively.
  
  
  CONCLUSIONS
  Mental well-being in later life is modifiable through exercise and physical activity. To generalise the findings, there is a need for more evidence of effectiveness from older people in the UK.
authors.affiliation: Institute of Medical and Social Care Research, Bangor University, Gwynedd, UK. g.windle@bangor.ac.uk
authors.forename: Gill
authors.initials: G
authors.lastname: Windle
authors.forename: Dyfrig
authors.initials: D
authors.lastname: Hughes
authors.forename: Pat
authors.initials: P
authors.lastname: Linck
authors.forename: Ian
authors.initials: I
authors.lastname: Russell
authors.forename: Bob
authors.initials: B
authors.lastname: Woods
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D010549:Personal Satisfaction