Efficacy of telemedicine interventions for depression and anxiety in older people: A systematic review and meta-analysis

Int J Geriatr Psychiatry. 2023 May;38(5):e5920. doi: 10.1002/gps.5920.

Abstract

Objectives: Anxiety and depression are prevalent in the elderly and lead to loss of functionality and increased mortality. Although the use of antidepressants and face-to-face psychotherapies are indicated, the current context of telemedicine provides an alternative, with the advantage of facilitating access to care. The study aimed to evaluate the efficacy of telemedicine interventions to reduce anxiety and depression in the elderly through a systematic review with meta-analysis.

Methods: The systematic review, through a search in 7 databases, included studies that evaluated the use of telemedicine interventions for depressive or anxious symptoms in the elderly, compared with usual care or waiting list or with another telemedicine intervention. Quantitative assessment was performed through meta-analysis.

Results: A total of 31 articles identified in the search met the eligibility criteria and four were included for meta-analysis. Studies showed that telemedicine interventions are feasible and several studies demonstrated significant improvement in depressive or anxiety symptoms. Four studies evaluated the efficacy of internet-delivered cognitive behavioral therapy for depression and anxiety in older adults, compared with a waitlist, and found pooled effect sizes of -1.20 (95% CI -1.60 to -0.81) and -1.14 (95% CI -1.56 to -0.72), respectively, with low heterogeneity.

Conclusions: Telemedicine interventions can be an alternative for the treatment of mood and anxiety symptoms in the elderly. However, more studies are needed to prove their clinical effectiveness, especially in countries with lower incomes and diverse culture and education.

Keywords: anxiety; depression; meta-analysis; older adults; systematic review; telemedicine.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anxiety / therapy
  • Anxiety Disorders / therapy
  • Cognitive Behavioral Therapy*
  • Depression / therapy
  • Humans
  • Telemedicine*