Dara Kiu Yi Leung, Lucy Xi Lu, Yun-Han Wang, Yun-Lin Wang, Artemis Sze Kok Fung, Katrina Tingan Jin
Twenty-one studies (N = 2,099) were identified, with 17 included in meta-analysis. Most interventions focused on physical activity, with few addressing sleep or nutrition and none targeting smoking or alcohol use. Pooled estimates derived mainly from physical activity interventions suggested a small reduction in depressive symptoms (SMD = -0.34, 95% CI -0.47 to -0.20). Subgroup analyses suggested reductions in depressive symptoms reached statistical significance only in hybrid physical activity interventions combining in-person sessions with technology-supported monitoring, but not in telephone-based or in-person formats. Most studies were rated as high risk of bias.
BACKGROUND AND OBJECTIVES: Informal caregivers of older adults often experience poorer lifestyle behaviors and elevated risks of physical and mental health problems. This systematic review and meta-analysis evaluated the effects of lifestyle interventions on behavioral, mental, and physical health outcomes among caregivers of older adults, and explored whether intervention characteristics influenced outcomes.
RESEARCH DESIGN AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO [anonymized for review]), a systematic search was conducted using PsycINFO, MEDLINE, and EMBASE up to 11 July 2025. Randomized controlled trials were included. Pooled estimates were calculated using random-effects meta-analysis. Risk of bias was assessed using the Revised Cochrane Risk of Bias tool.
RESULTS: Twenty-one studies (N = 2,099) were identified, with 17 included in meta-analysis. Most interventions focused on physical activity, with few addressing sleep or nutrition and none targeting smoking or alcohol use. Pooled estimates derived mainly from physical activity interventions suggested a small reduction in depressive symptoms (SMD = -0.34, 95% CI -0.47 to -0.20). Subgroup analyses suggested reductions in depressive symptoms reached statistical significance only in hybrid physical activity interventions combining in-person sessions with technology-supported monitoring, but not in telephone-based or in-person formats. Most studies were rated as high risk of bias.
DISCUSSION AND IMPLICATIONS: Preliminary findings, largely derived from physical activity interventions, suggest a small reduction in depressive symptoms, with no consistent effects for physical activity, sleep quality, caregiving burden, stress, or self-rated health. The evidence is limited in scope and methodological rigor. Future research may benefit from targeting a broader range of lifestyle behaviors.