A systematic review and meta-analysis of lifestyle interventions for informal caregivers of older adults: effects on behavioral change, mental health, and physical health
Abstract
Abstract Background and Objectives Informal caregivers of older adults often experience poorer lifestyle behaviors and elevated risks of physical and mental health problems. This systematic review and meta-analysis evaluated the effects of lifestyle interventions on behavioral, mental, and physical health outcomes among caregivers of older adults, and explored whether intervention characteristics influenced outcomes. Research Design and Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD42023439797), a systematic search was conducted using PsycINFO, MEDLINE, and EMBASE up to July 11, 2025. Randomized controlled trials were included. Pooled estimates were calculated using random-effects meta-analysis. Risk of bias was assessed using the Revised Cochrane Risk of Bias tool. Results 21 studies (N = 2,099) were identified, with 17 included in the meta-analysis. Most interventions focused on physical activity, few addressed sleep or nutrition and none targeted smoking or alcohol use. Pooled estimates derived mainly from physical activity interventions suggested a small reduction in depressive symptoms (SMD = −0.34, 95% CI −0.47 to −0.20). Subgroup analyses suggested that depressive symptom reductions reached statistical significance only in hybrid physical activity interventions combining in-person sessions with technology-supported monitoring, but not in telephone-based or in-person formats. Most studies were rated as high risk of bias. Discussion and Implications Preliminary findings, largely derived from physical activity interventions, suggest a small reduction in depressive symptoms, with no consistent effects for physical activity, sleep quality, caregiving burden, stress, or self-rated health. The evidence is limited in scope and rigor. Future research may target a broader range of lifestyle behaviors.