Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (Pexacog)

A feasibility study for a randomized controlled trial

Bibliographic Data

ID19536664
AuthorsKristine Sirevåg (0000-0002-2349-2306, Bergen Kommune, corresponding author), Silje Haukenes Stavestrand (0000-0002-7095-8754, Bergen Kommune), Trond Sjøbø (Bergen Kommune), Trygve Bruun Endal (0000-0003-3807-1018, Bergen Kommune), Hans M Nordahl (0000-0001-9275-646X, Norwegian University of Science and Technology), Erik Andersson (0000-0003-4433-1218, Karolinska Institutet), Inger Hilde Nordhus (0009-0005-8940-2050, University of Oslo), Å Rekdal (Bergen Kommune), Karsten Specht (0000-0002-9946-3704, University of Bergen), Åsa Hammar (0000-0002-3852-8551, Haukeland University Hospital), Anne Halmøy (0000-0003-2020-6164, Haukeland University Hospital), J Mohlman (William Paterson University), Helene Hjelmervik (0000-0002-4229-3441, Høyskolen Kristiania), Julian F Thayer (0000-0001-9385-3421, University of California, Irvine), Anders Hovland (0000-0003-3979-6627, Bergen Kommune)
Year2023
Volume17
Issue1
Pages25-25
Publication date2023-07-19
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBioPsychoSocial Medicine (JOURNAL)
Journal identifiersISSN: 1751-0759 • E-ISSN: 1751-0759
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/s13030-023-00280-7
PMID37468978
OpenAlexW4384820829
LanguageEN
References cited43

BACKGROUND: Generalised anxiety disorder (GAD) is a frequent and severe disorder among older adults. For older adults with GAD the effect of the recommended treatment, cognitive behaviour therapy (CBT), is reduced. Physical exercise (PE) may enhance the effect of CBT by improving cognitive function and increasing levels of brain-derived neurotrophic factor (BDNF), a predictor of the effect of CBT in patients with anxiety. The aim of the study was to assess the feasibility of a randomized controlled trial (RCT) investigating treatment effect of the combination of CBT and PE for GAD in a sample of older adults, including procedures for assessment and treatment. METHODS: Four participants aged 62-70 years (M = 65.5, SD = 3.2) with a primary diagnosis of GAD were included. Participants received 15 weeks of PE in combination with 10 weeks of CBT. Participants completed self-report measures, and clinical, biological, physiological and neuropsychological tests at pre-, interim- and post-treatment. RESULTS: Procedures, protocols, and results are presented. One participant dropped out during treatment. For the three participants completing, the total adherence to PE and CBT was 80% and 100%, respectively. An independent assessor concluded that the completers no longer fulfilled the criteria for GAD after treatment. Changes in self-report measures suggest symptom reduction related to anxiety and worry. The sample is considered representative for the target population. CONCLUSIONS: The results indicate that combining CBT and PE for older adults with GAD is feasible, and that the procedures and tests are suitable and manageable for the current sample. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02690441. Registered on 24 February 2016, https://clinicaltrials.gov/ct2/show/NCT02690441

Anxiety · Cognition · Cognitive behavioral therapy · Generalized anxiety disorder · Neuropsychology · Physical therapy · Population · Psychiatry · Randomized controlled trial · Worry · Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes · Cardiac Health and Mental Health · Clinical Psychology · Medicine · Mindfulness and Compassion Interventions · Psychology · Internal Medicine