Xinglu Li ¹ Shaokai He ^2* Tao Liu ^1* Xinxin Zhang ³ Wenfei Zhu ¹ Chao Wang ^1* Yuliang Sun ^1*

• ¹ Shaanxi Normal University, Xi'an, China
• ² Fuzhou Preschool Education College, Fuzhou, China
• ³ Guangxi Normal University, Guilin, Guangxi Zhuang Region, China

Objective: This systematic review and meta-analysis assessed the effects of three types of physical exercise (resistance exercise, aerobic exercise, and group exercise), different exercise intervention times (three months, six months), and different exercise intensities (low, moderate, and high) on the improvement of depressive symptoms in older adults aged ≥60 years, as well as to explore the impact of the sustainability of these physical exercise intervention programs on depressive symptoms in older adults.(2) Methods: The randomized controlled trials (RCTs) on the effect of physical exercise on depressive symptoms in older adults were retrieved from Cochrane Library, Web of Science, PubMed, and Embase Data. The retrieval time limit is from establishing the database to January 7, 2024. We conducted a meta-analysis using a 95% confidence interval (95% CI) and the standardized mean differences (SMD). The I 2 statistic was used to assess the heterogeneity of the outcomes of the studies. When I 2 < 50%, we used the fixed-effects model, and when I 2 > 50%, we used the random-effects model. Subgroup and sensitivity analyses investigated heterogeneity origins. (3) Results: There are 15 articles reported 20 studies, with a total of 1346 patients, including 689 in the control group and 657 in the experimental group. The findings demonstrated a notable improvement in depression symptoms among older persons as an immediate result of engaging in physical exercise [SMD = -0.82, 95% CI (-1.19, -0.45)]. The subgroup analysis showed that moderate-intensity physical exercise [SMD = -0.25, 95% CI (-0.47, -0.03)], high-intensity physical exercise [SMD = -0.94, 95% CI (-1.37, -0.51)], resistance exercise [SMD = -0.70, 95% CI (-1.20, -0.20)], and group exercise [SMD = -0.97, 95% CI (-1.89, -0.05)], and the exercise intervention time was 3 months [SMD = -0.81, 95% CI (-1.38, -0.23)] or 6 months [SMD = -0.93, 95% CI (-1.46, -0.41)] were more effective in improving depressive symptoms in older adults. (4) Conclusions: The sustainable resistance and group exercise have a better effect on improving depressive symptoms in older adults. Appropriate exercise intervention time can also ensure the sustainable improvement effect of exercise.