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Animal-assisted interventions (AAIs) - usually known as \u201cpet therapy\u201d - have emerged as promising complementary approaches, yet evidence synthesis remains fragmented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To comprehensively evaluate the effectiveness of AAI in reducing depressive symptoms among older adults through an umbrella review of systematic reviews and meta-analyses, incorporating trial sequential analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Embase, and Cochrane Library through September 2025 for systematic reviews and meta-analyses examining AAIs for depression in older adults. Quality assessment was performed using AMSTAR-2. We calculated the Corrected Covered Area to assess overlap between meta-analyses, re-analyzed primary study data to avoid double-counting, and conducted trial sequential analysis to evaluate evidence sufficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five systematic reviews encompassing 27 unique primary studies with 2,156 participants were included. The pooled random-effects meta-analysis demonstrated a significant reduction in depressive symptoms (SMD\u2009=\u20090.73; 95% CI: 0.57\u20130.89;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) with moderate heterogeneity (I\u00b2 = 43.4%). Trial sequential analysis revealed that the cumulative Z-curve crossed monitoring boundaries at 75% of the required information size, confirming evidence sufficiency. The Corrected Covered Area was 20.4%, indicating moderate overlap between meta-analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AAIs are associated with clinically meaningful reductions in depressive symptoms among older adults. Trial sequential analysis confirms that sufficient evidence exists to support this conclusion. AAIs represent a valuable, low-risk, patient-centered complement to conventional depression treatments in geriatric care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration<\/jats:title>\n                    <jats:p>[CRD420251250448]<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40520-026-03454-9","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T08:43:24Z","timestamp":1783154604000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Animal-assisted interventions for depression in older adults: an umbrella review with meta-analysis and trial sequential analysis"],"prefix":"10.1007","volume":"38","author":[{"given":"Marina","family":"De Rui","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Perencin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario Virgilio","family":"Papa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Doria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Ravelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Ceolin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ungar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Sergi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Devita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"3454_CR1","doi-asserted-by":"crossref","unstructured":"Zenebe Y, Akele B, W\/Selassie M, Necho M (2021) Prevalence and determinants of depression among old age: a systematic review and meta-analysis. 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