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Physical exercise augments cognitive behaviour therapy for older adults with generalized anxiety disorder : a randomized controlled trial

Stavestrand, Silje Haukenes ; Sirevåg, Kristine ; Nordhus, Inger Hilde ; Specht, Karsten ; Molde, Helge ; Nordahl, Hans M. ; Endal, Trygve Bruun ; Thayer, Julian F. ; Sjøbø, Trond and Mohlman, Jan , et al. (2025) In Cognitive Behaviour Therapy
Abstract

Generalized anxiety disorder (GAD) is a severe and prevalent disorder among older adults. Cognitive behaviour therapy (CBT) is recommended treatment for GAD, but older adults benefit less than younger peers. Physical exercise has been suggested to improve treatment efficacy. We aimed to determine the efficacy of augmenting CBT with physical exercise for older adults with GAD. This randomised controlled trial included 50 participants (mean [SD] age 66.52 [4.09] years; 39 [78%] female) with GAD. Participants received individual CBT and were randomised to either physical exercise or telephone attention placebo. The main outcome measure was self-reported worry on the Penn State Worry Questionnaire (PSWQ). Secondary outcome measures were... (More)

Generalized anxiety disorder (GAD) is a severe and prevalent disorder among older adults. Cognitive behaviour therapy (CBT) is recommended treatment for GAD, but older adults benefit less than younger peers. Physical exercise has been suggested to improve treatment efficacy. We aimed to determine the efficacy of augmenting CBT with physical exercise for older adults with GAD. This randomised controlled trial included 50 participants (mean [SD] age 66.52 [4.09] years; 39 [78%] female) with GAD. Participants received individual CBT and were randomised to either physical exercise or telephone attention placebo. The main outcome measure was self-reported worry on the Penn State Worry Questionnaire (PSWQ). Secondary outcome measures were clinician-rated remission and self-reported symptoms of anxiety, depression, and quality of life. Although the interaction between time and condition was statistically nonsignificant, moderation analysis revealed that this interaction was significant for participants with low treatment credibility to CBT at baseline. Participants randomised to physical exercise were five times more likely to achieve reliable long-term worry-reduction than placebo control. We found significant differences in favour of physical exercise for secondary measures of depression and anxiety. Participants with better cognitive inhibition at baseline were more likely to achieve clinician-rated remission. Findings suggest that physical exercise augments CBT for older adults with GAD.

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Contribution to journal
publication status
epub
subject
keywords
CBT, cognitive behaviour therapy, GAD, Generalised anxiety disorder, older adults, physical exercise
in
Cognitive Behaviour Therapy
publisher
Taylor & Francis
external identifiers
  • scopus:105023500930
ISSN
1650-6073
DOI
10.1080/16506073.2025.2592230
language
English
LU publication?
yes
id
530cbc25-4f3d-445e-b9c1-43127b937582
date added to LUP
2026-02-03 16:35:17
date last changed
2026-02-03 16:36:23
@article{530cbc25-4f3d-445e-b9c1-43127b937582,
  abstract     = {{<p>Generalized anxiety disorder (GAD) is a severe and prevalent disorder among older adults. Cognitive behaviour therapy (CBT) is recommended treatment for GAD, but older adults benefit less than younger peers. Physical exercise has been suggested to improve treatment efficacy. We aimed to determine the efficacy of augmenting CBT with physical exercise for older adults with GAD. This randomised controlled trial included 50 participants (mean [SD] age 66.52 [4.09] years; 39 [78%] female) with GAD. Participants received individual CBT and were randomised to either physical exercise or telephone attention placebo. The main outcome measure was self-reported worry on the Penn State Worry Questionnaire (PSWQ). Secondary outcome measures were clinician-rated remission and self-reported symptoms of anxiety, depression, and quality of life. Although the interaction between time and condition was statistically nonsignificant, moderation analysis revealed that this interaction was significant for participants with low treatment credibility to CBT at baseline. Participants randomised to physical exercise were five times more likely to achieve reliable long-term worry-reduction than placebo control. We found significant differences in favour of physical exercise for secondary measures of depression and anxiety. Participants with better cognitive inhibition at baseline were more likely to achieve clinician-rated remission. Findings suggest that physical exercise augments CBT for older adults with GAD.</p>}},
  author       = {{Stavestrand, Silje Haukenes and Sirevåg, Kristine and Nordhus, Inger Hilde and Specht, Karsten and Molde, Helge and Nordahl, Hans M. and Endal, Trygve Bruun and Thayer, Julian F. and Sjøbø, Trond and Mohlman, Jan and Andersson, Eva and Hammar, Åsa and Halmøy, Anne and Hovland, Anders}},
  issn         = {{1650-6073}},
  keywords     = {{CBT; cognitive behaviour therapy; GAD; Generalised anxiety disorder; older adults; physical exercise}},
  language     = {{eng}},
  publisher    = {{Taylor & Francis}},
  series       = {{Cognitive Behaviour Therapy}},
  title        = {{Physical exercise augments cognitive behaviour therapy for older adults with generalized anxiety disorder : a randomized controlled trial}},
  url          = {{http://dx.doi.org/10.1080/16506073.2025.2592230}},
  doi          = {{10.1080/16506073.2025.2592230}},
  year         = {{2025}},
}