HIGHLIGHTS
- •What is the primary question addressed by this study?These secondary data analyses examined long-term effects of CBT delivered by telephone and yoga on worry, anxiety, sleep, depressive symptoms, fatigue, physical function, social participation, and pain.
- •What is the main finding of this study?Six months after intervention completion, CBT and yoga RCT participants reported sustained improvements from baseline in worry, anxiety, sleep, depressive symptoms, fatigue, and social participation.
- •What is the meaning of the finding?These findings offer two solid evidence-based approaches (CBT and yoga) with long-term impact for treating worry in older adults.
ABSTRACT
Objectives
Cognitive-behavioral therapy (CBT) and yoga decrease worry and anxiety. There are
no long-term data comparing CBT and yoga for worry, anxiety, and sleep in older adults.
The impact of preference and selection on these outcomes is unknown. In this secondary
data analysis, we compared long-term effects of CBT by telephone and yoga on worry,
anxiety, sleep, depressive symptoms, fatigue, physical function, social participation,
and pain; and examined preference and selection effects.
Design
In this randomized preference trial, participants (N = 500) were randomized to a:
1) randomized controlled trial (RCT) of CBT or yoga (n = 250); or 2) preference trial
(selected CBT or yoga; n = 250). Outcomes were measured at baseline and Week 37.
Setting
Community.
Participants
Community-dwelling older adults (age 60+ years).
Interventions
CBT (by telephone) and yoga (in-person group classes).
Measurements
Penn State Worry Questionnaire - Abbreviated (worry);
1
,2
Insomnia Severity Index (sleep);
3
PROMIS Anxiety Short Form v1.0 (anxiety);
4
,5
Generalized Anxiety Disorder Screener (generalized anxiety);
6
,7
and PROMIS-29 (depression, fatigue, physical function, social participation, pain).
8
,9
Results
Six months after intervention completion, CBT and yoga RCT participants reported sustained
improvements from baseline in worry, anxiety, sleep, depressive symptoms, fatigue,
and social participation (no significant between-group differences). Using data combined
from the randomized and preference trials, there were no significant preference or
selection effects. Long-term intervention effects were observed at clinically meaningful
levels for most of the study outcomes.
Conclusions
CBT and yoga both demonstrated maintained improvements from baseline on multiple outcomes
six months after intervention completion in a large sample of older adults.
Trial Registration
www.clinicaltrials.gov Identifier NCT 02968238.
Key Words
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Article info
Publication history
Published online: February 06, 2022
Accepted:
February 1,
2022
Received in revised form:
January 31,
2022
Received:
October 26,
2021
Identification
Copyright
© 2022 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- The Humble Worrier - The Long-Term Impact of Using Yoga to Treat Severe Worry and Anxiety in Older AdultsThe American Journal of Geriatric PsychiatryVol. 30Issue 9
- PreviewOver the last decade, multiple reports have signaled the association of late-life anxiety and its phenotypes with increased morbidity and mortality. A 2014 study of 6,019 participants showed that higher anxiety symptoms were prospectively associated with increased risk of incident stroke independent of all other risk factors, including depression.1 The independent effect of anxiety on increasing the risk of cognitive decline has been documented in several recent studies,2 including longitudinal studies indicating an increased association between amyloid burden, and anxiety symptoms in cognitively normal older adults.
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