Effectiveness of web-based interventions on depression and anxiety in older adults: a systematic review and meta-analysis of randomized controlled trials

초록

Objective: This study examined the effects of web-based interventions on depression and anxiety in older adults. Methods: We conducted a systematic search of PubMed, CINAHL, Cochrane, Embase, PsycINFO, and Web of Science from their inception to March 05, 2025. We included randomized controlled trials (RCTs) examining the effects of web-based interventions on depression and anxiety in individuals aged 60 and older. The quality of included studies was evaluated using the revised Cochrane risk-of-bias tool for RCTs. A random-effects model was applied for the meta-analysis, with pooled standardized mean differences (SMD) used to estimate intervention effects. Heterogeneity was quantified using the I2 statistic, and subgroup and meta-regression analyses were performed to investigate potential moderators. Results: A total of 19 studies were included in the final analysis. The meta-analysis showed that web-based interventions significantly reduced depression (SMD =-0.48, 95 % CI =-0.72 to-0.24) and anxiety (SMD =-0.70, 95 % CI =-0.97 to-0.43) in older adults. Subgroup analyses indicated that participant characteristics and publication year significantly moderated heterogeneity, while meta-regression analysis revealed that mean age significantly moderated the intervention effect. Conclusion: This meta-analysis confirmed that web-based interventions effectively reduce depression and anxiety in older adults. The effects were particularly pronounced among older adults with existing or diagnosed symptoms of depression or anxiety. Furthermore, the observed reduction in intervention effectiveness after COVID-19 highlights the need to investigate the underlying causes of this decline.

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