A systematic review of the available research indicates that horticultural therapy, which involves plants, gardens, and gardening activities, may be effective in relieving depression symptoms in older adults. The greatest benefits were found for those in care-providing settings who participated in horticultural therapy for four to eight weeks.
In the last century, life expectancy, or how long people live, has dramatically increased in many countries around the world. This group of individuals represents a large and growing segment of the population, and this has become a major social problem. There is ample research effort underway to enhance the quality of life of the elderly.
Due to their peers dying of old age, reduced social contact, and living alone, elderly individuals suffer various types of psychosocial stress, all of which may exacerbate feelings of loneliness and helplessness, increasing the risk of depression. Depression can cause serious bodily harm, including mental illness.
Researchers are looking for non-pharmacological treatments to treat depression for a long time. One of the most promising non-pharmacological alternatives is horticultural therapy.
Previous studies have shown that it works for a wide range of people, including healthy people, dementia patients, and depressive symptoms. However, there are many more studies that are attempting to provide a complete picture of their findings.
Meijing Xu and his colleagues wanted to evaluate the previous findings and gain a complete understanding of the effects of horticultural therapy on older adults with depression. They conducted a systematic review (following PRISMA guidelines).
Researchers searched for relevant papers published until September 25th 2022 in PubMed, Embase, Medline, CINAHL, Web of Science, Scopus, and four Chinese databases—CNKI, Wanfang Data, VIP Data, and Chinese BioMedical Literature Database (CBM).
Experimental or quasi-experimental studies on people aged 60 or older that examined the effects of horticultural therapy and included a psychological assessment as the outcome were excluded from the analysis, as well as conference papers and dissertations.
The final review of a sample of 13 studies, published in 12 papers, was conducted in China, three in Korea, three in Japan, and one in Poland. Eight of these studies assessed depression using the 15-item Geriatric Depression Scale (GDS-15), with the remaining five using the 30-item Geriatric Depression Scale (GDS-30). In terms of the environmental setting, four studies were conducted in communities, three in special care facilities, and one in a hospital.
Overall, studies demonstrated that horticultural therapy treatments performed better than control groups, despite significant differences in effects.
Researchers examined horticultural therapies in which participants were involved in planting, while others simply strolled through gardens. Studies that produced effects were those that involved participants in planting, while those that did not have any effect on depression symptoms were those that just walked through gardens.
When considering the duration of the horticultural therapy, findings revealed that in treatments that lasted more than eight weeks, there was little difference between experimental and control groups. However, findings were found in studies lasting up to eight weeks.
“Care-providing settings were shown to have higher therapeutic effects,” according to the authors. Participatory activities [in which participants participate in planting or gardening activities] produced better outcomes than observational activities [in which participants just walked through gardens].
The research contributes to the systematic review of scientific knowledge on the effects of horticultural care on the elderly population. However, all studies included in the analysis except for one were conducted in countries in east Asia. The results on other cultures may not be the same.
Meijing Xu, Shan Lu, Jianjiao Liu, and Feng Xu wrote the paper 'Effectiveness of horticultural therapy in elderly people with depression: A systematic review and meta-analysis.'