Behavioural activation for depression in older people: systematic review and meta-analysis.

Abstract

<b>Background</b>Behavioural activation is an effective treatment for depression in the general adult population but it is unclear whether it is effective for older people.<b>Aims</b>To systematically review randomised controlled trials (RCTs) of behavioural activation for depression in older people.<b>Method</b>We searched Medline, EMBASE, PsycINFO, CINAHL and online trial registers for RCTs of behavioural activation for depression in older people.<b>Results</b>Eighteen trials were included in the meta-analyses. Behavioural activation reduced mean depression scores for older people living in the community as a stand-alone treatment: standardised mean difference (SMD) -0.72, 95% Cl -1.04 to -0.41. It was also effective as part of a multicomponent intervention (SMD -0.44, 95% CI -0.56 to -0.32).<b>Conclusions</b>Behavioural activation significantly reduces depressive symptoms in older people in the community; however, given that most studies are small and with significant bias results should be interpreted with caution. Further high-quality trials of behavioural activation for this age group are needed.