Is exercise effective in promoting mental well-being in older age? A systematic review.
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.
Windle
Gill
G
Institute of Medical and Social Care Research, Bangor University, Gwynedd, UK. g.windle@bangor.ac.uk
Hughes
Dyfrig
D
Linck
Pat
P
Russell
Ian
I
Woods
Bob
B
D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D010549:Personal Satisfaction