Objective: Transcranial magnetic stimulation (TMS) is a form of neuromodulation used to treat various neuropsychiatric disorders. The clinical utility of TMS in older adults with depression is less studied. This review was conducted to compile the study findings on the efficacy and adverse effects of TMS in later-life depression to elucidate gaps in the literature and formulate recommendations. Materials and methods:A search was conducted on PubMed, Scopus and Ovid databases with search terms based on the three domains of our research questions, namely "transcranial magnetic stimulation", "depression", and "later life". All the articles published in English until June 2021 were incorporated and critically appraised after fulfilling inclusion and exclusion criteria. Results: A total of 643 articles were screened with title and abstract, and 41 were selected for full-text assessment. Finally, 26 articles were included after scrutiny and findings were tabulated. This consisted of 8 randomized controlled trials (RCTs), six open-label, one retrospective study, 4 case series and 7 case reports. Available findings in this area so far are mixed and inconclusive. Level I evidence for the use of TMS in later-life depression is lacking. Conclusion: Evidence regarding the efficacy of TMS in the treatment of depression in older adults lacks consistency in the outcomes, which warrants an urgent need for systematic review and meta-analysis of RCTs on the use of TMS in later-life depression.
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