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The Humble Worrier - The Long-Term Impact of Using Yoga to Treat Severe Worry and Anxiety in Older Adults

  • Carmen Andreescu
    Correspondence
    Send correspondence and reprint requests to Carmen Andreescu, M.D., Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA.
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    Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
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Published:February 26, 2022DOI:https://doi.org/10.1016/j.jagp.2022.02.008
      Over 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.
      • Lambiase MJ
      • Kubzansky LD
      • Thurston RC
      Prospective study of anxiety and incident stroke.
      The independent effect of anxiety on increasing the risk of cognitive decline has been documented in several recent studies,
      • Santabarbara J
      • Lipnicki DM
      • Olaya B
      • et al.
      Does anxiety increase the risk of all-cause dementia? An updated meta-analysis of prospective cohort studies.
      including longitudinal studies indicating an increased association between amyloid burden, and anxiety symptoms in cognitively normal older adults.
      • Hanseeuw BJ
      • Jonas V
      • Jackson J
      • et al.
      Association of anxiety with subcortical amyloidosis in cognitively normal older adults.
      The effect of anxiety on cognition appears as early as midlife: in the Nurses’ Health Study, a 4-year longitudinal study of community-dwelling older women (N = 16,351), higher midlife anxiety was related to worse later-life overall cognitive function, and verbal memory. Overall, anxiety may be an even stronger risk factor for medical comorbidity than depression,
      • O'Donovan A
      • Slavich GM
      • Epel ES
      • et al.
      Exaggerated neurobiological sensitivity to threat as a mechanism linking anxiety with increased risk for diseases of aging.
      ,
      • Tully PJ
      • Cosh SM
      • Baumeister H
      The anxious heart in whose mind? A systematic review and meta-regression of factors associated with anxiety disorder diagnosis, treatment and morbidity risk in coronary heart disease.
      but the persistent perception of anxiety symptoms as a relatively mild group of heterogenous "negative affect" symptoms with no relevant impact beyond decreased quality of life continues to persist in the medical community.
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      References

        • Lambiase MJ
        • Kubzansky LD
        • Thurston RC
        Prospective study of anxiety and incident stroke.
        Stroke. 2014; 45: 438-443
        • Santabarbara J
        • Lipnicki DM
        • Olaya B
        • et al.
        Does anxiety increase the risk of all-cause dementia? An updated meta-analysis of prospective cohort studies.
        J Clin Med. 2020; 9 (Published online Jun 9, 2020. PMCID: PMC7355582.): 1791https://doi.org/10.3390/jcm9061791
        • Hanseeuw BJ
        • Jonas V
        • Jackson J
        • et al.
        Association of anxiety with subcortical amyloidosis in cognitively normal older adults.
        Mol Psychiatry. 2020; 25: 2599-2607
        • O'Donovan A
        • Slavich GM
        • Epel ES
        • et al.
        Exaggerated neurobiological sensitivity to threat as a mechanism linking anxiety with increased risk for diseases of aging.
        Neurosci Biobehav Rev. 2013; 37: 96-108
        • Tully PJ
        • Cosh SM
        • Baumeister H
        The anxious heart in whose mind? A systematic review and meta-regression of factors associated with anxiety disorder diagnosis, treatment and morbidity risk in coronary heart disease.
        J Psychosom Res. 2014; 77: 439-448
        • Gordon D
        • Heimberg RG
        Reliability and validity of DSM-IV generalized anxiety disorder features.
        J Anxiety Disord. 2011; 25: 813-821
        • Rutter LA
        • Brown TA
        Reliability and validity of the dimensional features of generalized anxiety disorder.
        J Anxiety Disord. 2015; 29: 1-6
        • Paulus MP
        • Stein MB
        An insular view of anxiety.
        Biol Psychiatry. 2006; 60: 383-387
        • Stanley MA
        • Beck JG
        • Novy DM
        • et al.
        Cognitive-behavioral treatment of late-life generalized anxiety disorder.
        J Consult Clin Psychol. 2003; 71: 309-319
        • Andreescu C
        • Lee S
        Anxiety disorders in the elderly.
        Adv Exp Med Biol. 2020; 1191: 561-576
        • Karim HT
        • Tudorascu DL
        • Butters MA
        • et al.
        In the grip of worry: cerebral blood flow changes during worry induction and reappraisal in late-life generalized anxiety disorder.
        Transl Psychiatry. 2017; 7: e1204

      Linked Article

      • Long-Term Effects of Cognitive-Behavioral Therapy and Yoga for Worried Older Adults
        The American Journal of Geriatric PsychiatryVol. 30Issue 9
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          Cognitive-behavioral therapy (CBT) and yoga have been shown to decrease worry and anxiety. CBT is the most efficacious non–pharmacologic treatment for worry10 and has the strongest evidence base for treating late-life worry and related symptoms11 although some studies have failed to demonstrate a superior effect of CBT to active comparison interventions.12,13 Regarding the selection of yoga to target worry, following our previous randomized controlled trial (RCT),14 participants provided feedback that they were interested in yoga as a treatment option for worry and anxiety and would like to be able to choose their treatment.
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