Meta-analysis2025Open access

The effectiveness of the Chinese Five-Element Music intervention on older adults with depression and anxiety disorder: A systematic review and meta-analysis

Li J, Chen K, Wang IT, Beh WF

Medicine · 2 citations

Review labels

Funding not disclosed

Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.

How it was studied

Design
Meta-analysis (indexed by PubMed)
Studied in
People
Main outcome
Health markers and function

Who paid for it

Funding
Funding not disclosed

Publication

Published
2025-10-03 · Medicine (Baltimore) · vol. 104 · issue 40 · p. e44764
Publisher
Wolters Kluwer
Cited
4 citations · more than 75% of similar papers · 1.1× the field average
References
8 works
Access
Open access (journal) · CC-BY-NC
Research areas
Music Therapy and Health · Neuroscience and Music Perception · Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
Intervention (counseling), Depression (economics), Anxiety, Randomized controlled trial, Quality of life (healthcare), MEDLINE
MeSH
humans, treatment outcome, music therapy, depression, anxiety disorders, quality of life, aged, female, randomized controlled trials as topic

4 authors

From MY

  • Jiayin LiUniversity of Malaya
  • Kanghao ChenUniversity of Malaya
  • Wang TaUniversity of Malaya
  • Wen Fen Beh · correspondingUniversity of Malaya

Abstract

Background

Depression and anxiety are among the most prevalent mood disorders worldwide, affecting hundreds of millions of people and contributing to significant disability, particularly in older adults. Conventional treatments such as pharmacotherapy and psychotherapy are effective but often limited by side effects or accessibility. As a complementary approach, Chinese Five-Element Music (CFEM), rooted in Traditional Chinese Medicine, aims to restore emotional balance through the connection between musical tones, organ systems, and emotions. Recent studies suggest its potential to alleviate psychological symptoms, yet evidence in older populations remains limited.

Methods

The systematic review identified and mapped available literature on CFEM interventions, guiding the selection and analysis of randomized controlled trials (RCTs) for meta-analysis. Databases including Web of Science, PubMed, CNKI, Wanfang, and CQVIP were searched in March 2025. Eighteen RCTs were included. Outcome measures assessed included the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Zung Self-Rating Depression and Anxiety Scales (SDS and SAS), Pittsburgh Sleep Quality Index (PSQI), overall response rate (ORR), and Quality of Life (QOL). The risk of bias was assessed using the Cochrane Handbook criteria. Most studies reported adequate randomization, but blinding methods were often unclear.

Results

A meta-analysis using a random-effects model was conducted on 18 RCTs. The results indicated that, compared to conventional care, the CFEM intervention significantly alleviated symptoms in older adults with depression and anxiety. Specifically, the outcomes were as follows: HAMD score (MD = -3.63, 95% CI: -4.97 to -2.3, P < .00001), HAMA score (MD = -3.89, 95% CI: -5.80 to -1.97, P < .0001), SAD score (MD = -6.69, 95% CI: -8.32 to -5.07, P < .00001), SAS score (MD = -6.84, 95% CI: -10.76 to -2.92, P = .0006), ORR score (95% CI: 1.61 to 4.89, P = .0003), QOL score (MD = -0.58, 95% CI: -15.65 to 14.48, P = .94), PSQI score (MD = -1.86, 95% CI: -2.54 to -1.17, P < .00001).

Conclusion

CFEM may be an effective complementary intervention to alleviate depression, anxiety, and sleep problems in older adults. However, due to moderate study quality and lack of blinding, further high-quality trials are needed.

Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC).

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