The effect of horticultural therapy on depressive symptoms among the elderly: A systematic review and meta-analysis

Abstract

ObjectiveThis systematic review and meta-analysis aimed to assess the effectiveness of horticultural therapy on depressive symptoms in the elderly and determine the potential moderators of the intervention effect.MethodsIn early June 2022, randomized controlled trials and Quasi-experimental studies were searched on Web of Science, PsycINFO, CINAHL, EMBASE, Medline, PubMed, CNKI, WANFANG DATA, and CQVIP. Three independent authors proposed the following inclusion criterion for this study: the elderly with applied horticultural therapy intervention compared to non-HT intervention. From a total of 3,068 records, only 34 studies met the inclusion criteria. After the full-text screening, 13 studies were included in the analysis. An assessment of the risk of bias was conducted using RoBINS-I and RoB 2 tools. The comprehensive Meta-Analysis 3.3 tool was used for the meta-analysis.ResultsMeta-analysis suggested that mean depression scores of elderly people who underwent horticultural therapy intervention were significantly lower than those who did not receive HT therapy. More significant effects were found for the elderly with mean age equal to or over 75 years instead of younger than 75 years, in randomized controlled trials instead of quasi-experimental studies, for studies with more than 20 participants receiving horticultural therapy at the same time and place instead of equal to or fewer than 20 horticultural therapy participants.ConclusionsThis evidence supported that horticultural therapy had a significant positive effect on the depressive symptoms outcomes for the elderly. Therefore, our data revealed that horticultural therapy could be considered as a part of therapy in depressive symptoms reduction programs. Due to the high degree of heterogeneity and the limited number of studies, a future review is warranted to determine the effects of horticultural therapy on depressive symptoms reduction in the elderly.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=272464, identifier: CRD42021272464.

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“…In the study conducted by Kim et al with participants composed of middle-aged women, it was discerned that, among interventions, the horticultural therapy was of signi cance to participants' depression, anxiety, and self-de nition, and in this respect, the experimental group exhibited more signi cant developments than the control group [50]. In the metaanalysis performed by Zhang et al to identify the effect of horticultural therapy on depressive symptoms, it was indicated that horticultural therapy had a positive effect on the consequences of depressive symptoms [51]. In the study by Noone et al and in the study by Domenceh-Abella et al, it was stated that horticultural activities that were performed collectively promoted community integration by developing social attachment and were a tool for the alleviation of individuals' depressive symptoms, which stemmed from loneliness and the lack of social interaction [52][53].…”

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“…The review by Coventry et al [ 9 ] reported a beneficial role of gardening in reducing symptoms of anxiety and negative effects in people with several mental illnesses. Horticultural therapy was also found to be effective in reducing depressive symptoms and improving cognitive performance [ 10 , 21 , 26 , 27 , 33 , 40 , 42 , 50 , 54 ].…”

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