Traditional Chinese Medicine in the Treatment of Late-Life Depression: A Review of Recent Advances and Clinical Implications

Late-life depression (LLD, onset ≥60 years) is a common and disabling condition, often inadequately managed with conventional pharmacotherapy due to limited efficacy, adverse effects, and polypharmacy risks. Traditional Chinese medicine (TCM) offers multimodal interventions that may complement modern treatment. Recent studies demonstrate that herbal medicine, acupuncture, moxibustion, and exercise therapy can relieve depressive symptoms through the regulation of monoamine neurotransmitters, enhancement of brain-derived neurotrophic factor (BDNF), modulation of the hypothalamic–pituitary–adrenal (HPA) axis, and protection of hippocampal function. Acupuncture and exercise have shown preliminary evidence of improving neuroendocrine balance and cognitive performance, while integrative approaches combining TCM with antidepressants may provide improved clinical outcomes and reduced adverse effects in some studies, although the evidence remains heterogeneous and should be interpreted cautiously compared with pharmacotherapy alone. Despite promising findings, current evidence is constrained by heterogeneous protocols, small sample sizes, and insufficient long-term safety data. Future research should emphasize standardized regimens, large-scale randomized controlled trials, and integrative strategies to optimize outcomes and quality of life in elderly patients with depression.