Comparative effects of activity-based interventions on quality of life among community-dwelling older adults: A systematic review and Bayesian network meta-analysis.
Jisu Seo, Yuelin Li, Rhayun Song
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In 30 seconds
This systematic review and Bayesian network meta-analysis examined activity-based interventions and quality of life (QoL) in community-dwelling older adults aged 65 years or older. It included 71 randomised controlled trials with 12,159 participants, comparing social, physical, and self-directed activities. Network estimates suggested that each category may improve QoL versus no treatment: self-directed activities had an SMD of 0.78 (95% CrI 0.25-1.32), physical activities 0.73 (0.46-1.00), and social activities 0.40 (0.11-0.69). Evidence did not establish that one category was superior.
Key findings
- Across interventions, the pairwise estimate favored activity-based interventions (SMD=0.59, 95% CI 0.45-0.73), but certainty was very low and the prediction interval crossed the null.
- Network estimates versus no treatment were SMD=0.78 (95% CrI 0.25-1.32) for self-directed, 0.73 (0.46-1.00) for physical, and 0.40 (0.11-0.69) for social activities; evidence was low certainty.
- Excluding high-risk studies, the overall pairwise estimate was 0.53 (0.37-0.69); the physical-activity estimate remained 0.61, while social and self-directed estimates were 0.43 and 0.45.
Why it matters
The findings suggest that participation in varied activities may support QoL among community-dwelling older adults, while offering no reliable basis for choosing one activity category over another. The low or very-low certainty and substantial heterogeneity mean that apparent differences in estimates and rankings should not be interpreted as established comparative benefits.
What to keep in mind
The authors note heterogeneity, risk of bias, potential publication bias, and sparse direct comparisons between active interventions. Comparative rankings are hypothesis-generating.