Effectiveness of physiotherapy techniques on depressive symptoms in older adults: a systematic review

Abstract

Introduction: The older adult population suffers from a high prevalence of depression, representing an increasing burden on healthcare systems. In this context, this systematic review evaluated the effectiveness of physiotherapy for the management of depressive symptoms in this population. The population aged 65 and over is increasing in developed countries such as Spain, currently accounting for 19.09% and projected to reach 25.2% within the next decade. Depression is one of the most prevalent mental health conditions in this group, affecting 5% of community-dwelling individuals and 25% in institutional settings, significantly reducing quality of life and increasing the risk of dementia. While the pharmacological and psychotherapeutic treatments are standard, they present adverse effects and limitations in this population, prompting the exploration of physiotherapy as a non-pharmacological alternative.

Objective: To analyze the scientific evidence regarding the effectiveness of combining conventional treatments with physiotherapy techniques for symptomatic improvement in older patients with depression, and to identify the most effective physiotherapy technique, when combined with conventional treatment, for depressive symptoms in older adults.

Methods: We conducted a systematic review following PRISMA guidelines, and we performed searches in PubMed, Web of Science (WOS), Scopus and Cochrane Library databases. Study quality and risk of bias were assessed using the Cochrane Collaboration's tool.

Results: Eight randomized controlled trials, encompassing a total of 1,368 older participants diagnosed with depression or depressive symptoms who received physiotherapy, were included. The findings indicate that physiotherapy techniques, particularly therapeutic exercise, in combination with conventional treatments, may improve depressive symptoms in this population.

Conclusion: Although we observed positive trends in the effectiveness of physiotherapy for depression in older adults, further research is required to validate its clinical efficacy and inform evidence-based treatment guidelines.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251079161.

Keywords: depression; effectiveness; older adult; physiotherapy; systematic review.

Figure 1

PRISMA 2020 flow diagram. © 2025 by José Lesmes Poveda-López is licensed under Creative Commons Attribution 4.0 International. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.

Figure 2

Forest plot of the standardized mean difference (Cohen’s d) for the effect of physiotherapy on depressive symptoms in older adults. © 2025 by Ana Aguilera Gonzalo is licensed under CC BY 4.0. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.

Figure 3

Risk of bias graph. © 2025 by José Lesmes Poveda-López is licensed under Creative Commons Attribution 4.0 International. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.