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

Background Behavioural activation is an effective treatment for depression in the general adult population but it is unclear whether it is effective for older people. Aims To systematically review randomised controlled trials (RCTs) of behavioural activation for depression in older people. Method We searched Medline, EMBASE, PsycINFO, CINAHL and online trial registers for RCTs of behavioural activation for depression in older people. Results 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% CI -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). Conclusions 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.