Effects of mind-body exercises on depressive symptoms in older adults: a comprehensive umbrella review of the evidence

This is the authors' abstract. We don't add key points for this paper.

Background Depression is common in older adults, often with suboptimal pharmacological responses. Mind-body exercises (MBEs) like Tai Chi, Yoga, and Qigong have emerged as potentially beneficial non-pharmacological interventions. However, existing systematic reviews report heterogeneous findings, necessitating a comprehensive synthesis of the available evidence. Methods We systematically searched PubMed, Cochrane Library, Web of Science, and ScienceDirect to August 2025, following PRISMA and PRIOR guidelines. Systematic reviews and meta-analyses examining MBEs' effects on depressive symptoms in adults ≥60 years were included. The Corrected Covered Area (CCA) assessed overlap between reviews. Effect sizes were synthesized using random-effects modeling. Quality was assessed via AMSTAR-2 and GRADE. Results Twenty-five reviews (>20,000 participants) were included, with moderate overlap (CCA = 6.98%). The synthesized evidence suggested moderate reductions in depressive symptoms (pooled SMD = −0.51, 95% CI: −0.66 to −0.35, p < 0.0001). Subgroup analyses showed larger effect sizes for Qigong (SMD = −0.49) vs. Yoga (SMD = −0.45) and Tai Chi (SMD = −0.34). However, substantial heterogeneity was observed ( I 2 = 90.89%). Sensitivity analyses confirmed robustness. Trim-and-fill adjustment suggested potential publication bias (adjusted SMD = −0.40). Conclusion This umbrella meta-analysis provides moderate-certainty evidence that MBEs, particularly Qigong, may be associated with reductions in depressive symptoms in older adults, though the substantial heterogeneity ( I 2 = 90.89%) across included reviews indicates that pooled estimates should be interpreted as reflecting a general directional trend rather than definitive effect sizes. A quality-stratified sensitivity analysis restricted to High Confidence reviews yielded a stronger and homogeneous effect (SMD = −0.62, I 2 = 0.0%). However, the predominance of lower-quality reviews and evidence of publication bias necessitate cautious interpretation. These findings provide a directional evidence synthesis to inform future high-quality research rather than definitive clinical recommendations. Systematic Trial Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251131812 , Identifer [PROSPERO 2025 CRD420251131812].