Comparative effectiveness of digitally delivered psychological therapies for depression and anxiety symptoms in older adults: A systematic review and network meta-analysis.

Background: Digitally delivered psychological therapies are increasingly used for older adults, but their effectiveness for depression and anxiety remains unclear.

Methods: Randomized Controlled Trials (RCTs) on digitally delivered psychological therapies were searched in databases including Pubmed, Web of Science, Cochrane Library, Medline, CINAHL, PsycINFO, and Embase. The search time was from the establishment of the database to September 2024. The quality of the included RCTs was evaluated by two trained researchers using the Cochrane Risk of Bias Assessment Tool. Data extraction and analysis were conducted independently using Network Meta-analysis (NMA) with Stata 18.0 statistical software.

Results: A total of 28 studies, encompassing six different digitally delivered psychological therapies and involving 4000 older adults, were included in this review. The NMA demonstrated that digitally delivered psychological therapies are effective in alleviating symptoms of both depression and anxiety symptoms in older adults. Specifically, digital Reminiscence therapy (RT) may be more effective in alleviating depressive symptoms (SMD: -7.60, 95 % CI: -13.92 to -1.28) than other interventions. For anxiety symptoms, digital Cognitive Behavioral Therapy (CBT) may be more effective (SMD: -3.11, 95 % CI: -4.25 to -1.96).

Conclusions: The existing evidence shows that digital RT may be more effective for reducing depression symptoms, while digital CBT is more effective for anxiety symptoms. However, due to the diversity of psychological therapies and the small number of studies included in each therapy, the coverage of this study may not be comprehensive. Future research should prioritize large-sample, multi-center, and high-quality RCTs to further validate these results.