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Horticultural therapy may improve physical and emotional health outcomes in older adults

Wang Z, Zhang Y, Lu S, et al. Horticultural therapy for general health in the older adults: A systematic review and meta-analysis PLoS ONE. 2022;17:e0263598.

Review question

What is the effect of horticultural therapy on general health in older adults? 


The rapid aging of the global population has highlighted the need to find and implement cost-effective strategies that promote healthy aging. For many years, horticultural therapy has been broadly accepted as a complementary and alternative strategy. Horticultural therapy involves engaging in garden-related activities—such as growing fruits and vegetables and potting plants—that are guided by a trained therapist and aim to help people achieve specific health-related goals. Despite its wide acceptance, the health-promoting effects of horticultural therapy remain unclear in older adults; therefore, a comprehensive review of the evidence is needed.  

How the review was done

This is a systematic review and meta-analysis of 15 studies, mainly randomized controlled trials. The studies were published between 2010 and 2021 and included a total of 1046 participants. Key features of the studies:

  • Participants were older adults (over 60 years of age) ranging in health status from healthy to those with a wide variety of mental, cognitive, and physical conditions—such as depression, anxiety, Alzheimer’s, dementia, frailty, high blood pressure, diabetes, and arthritis.
  • Participants engaged in horticultural therapy for 1-2 hours per week and a total of 1.5 to 12 months.
  • Researchers measured changes in quality of life, physical function, body mass index (BMI), and mood.
  • Outcomes were compared to control groups generally engaging in traditional activities, doing nothing, or placed on a waiting list to eventually participate in a gardening intervention.

What the researchers found

Horticultural therapy may help improve physical function, quality of life, BMI, and mood in older adults. Improvements in mood—namely the feeling of happiness—were only seen in healthy people, whereas increases in quality of life were only seen in those with mild Alzheimer’s disease. The evidence was of moderate quality, as a result, future research may produce different findings. A greater number of high-quality studies with more participants and less variability in how they are conducted is needed to solidify these findings.


Horticultural therapy shows the potential to produce positive effects on physical and emotional health outcomes—namely physical function, BMI, mood, and quality of life—in older adults in certain instances.


Control group
A group that receives either no treatment or a standard treatment.
Advanced statistical methods contrasting and combining results from different studies.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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