{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T05:04:55Z","timestamp":1783919095134,"version":"3.55.0"},"reference-count":80,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluated the effects of traditional Chinese mind\u2013body exercises on depressive symptoms in middle-aged and older adults and examined potential dose-related and study-level moderators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, and Wanfang were searched through May 3, 2026, for randomized controlled trials. A three-level random-effects model was used to account for dependent effect sizes. Subgroup analyses, meta-regression, exploratory dose\u2013response analyses, and an XGBoost-based machine-learning extension were conducted. The risk of bias and the certainty of evidence were assessed using RoB 2 and GRADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty randomized controlled trials were included. Traditional Chinese mind\u2013body exercises were associated with a statistically significant reduction in depressive symptoms among middle-aged and older adults (SMD\u202f=\u202f\u22120.88; 95% CI, \u22121.18 to \u22120.58;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Sensitivity and supplementary analyses generally supported the robustness of the main findings; however, substantial heterogeneity and risk of bias contributed to low certainty of the evidence. Subgroup analyses indicated that most estimates favored traditional Chinese mind\u2013body exercises, with statistically significant subgroup differences observed only by country. Meta-regression showed that older age was associated with a smaller intervention effect (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.025). Exploratory dose\u2013response analyses did not identify a statistically supported optimal dose, although descriptive patterns were observed. XGBoost and SHAP analyses suggested that age, scale type, total dose, and session duration may be important study-level features, though these findings were exploratory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Traditional Chinese mind\u2013body exercises may reduce depressive symptoms in middle-aged and older adults; however, the certainty of the evidence is low because of substantial heterogeneity and risk of bias. Dose\u2013response and machine-learning findings should be considered exploratory. Further high-quality randomized controlled trials are warranted to confirm these findings and refine intervention parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261388878<\/jats:ext-link>\n                      , identifier PROSPERO (CRD420261388878).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1887582","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:23:37Z","timestamp":1783916617000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of traditional Chinese mind\u2013body exercises on depressive symptoms in middle-aged and older adults: a multilevel meta-analysis with exploratory dose\u2013response and machine learning analyses"],"prefix":"10.3389","volume":"17","author":[{"given":"Xuesong","family":"Yang","sequence":"first","affiliation":[{"name":"School of Wushu and Performance, Capital University of Physical Education and Sports","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwei","family":"Guo","sequence":"additional","affiliation":[{"name":"Shanghai University of Sport","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingquan","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Sport Management and Communication, Capital University of Physical Education and Sports","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1038\/s41398-019-0514-6","article-title":"Mechanisms and treatment of late-life depression","volume":"9","author":"Alexopoulos","year":"2019","journal-title":"Transl. 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