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A systematic review and meta-analysis on physical activity for the treatment of anxiety in older adults
Zahra Goodarzi1, AnneMarie Levy2, Carly Whitmore3
1Department of Medicine, Division of Geriatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.
Objectives:
Symptoms of anxiety and anxiety disorders negatively impact the quality of life of older adults. Physical activity is a potentially accessible intervention with other health benefits and minimal risk, yet its impact on anxiety in older adults is unclear.
Design:
Systematic review and meta-analysis.
Setting:
Included databases were MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO and CINHAL were searched from inception to June 23, 2023.
Participants, Interventions, Measurements:
We included randomized controlled trials of older adults who reported anxiety symptoms or disorders at baseline, that compared physical activity interventions with a non-physical activity comparator. All steps were done in duplicate, and certainty of evidence was with Grading of Recommendations, Assessment, Development, and Evaluations. Random effects meta-analyses were performed.
Results:
10,763 citations were reviewed, 13 studies were included in meta-analyses. At baseline, participants self-reported low to moderate levels of anxiety and different levels of fitness. In the meta-analysis, the physical activity intervention had a medium effect in decreasing the severity of anxiety symptoms compared to the control (standardized mean differences (SMD) - 0.66; 95 % Confidence Interval (CI) - 0.89, - 0.43). Subgroup analyses indicated reductions in symptom severity when only assessing the effects of in-person interventions (SMD: - 0.59; 95 %CI: - 0.79, - 0.38), studies of participants without pre-existing diseases (SMD: - 0.74; 95 % CI: - 0.99, - 0.50), resistance training (SMD: - 0.76; 95 % CI: - 1.15, - 0.38) and aerobic exercise (SMD: - 0.82; 95 % CI: - 1.15, - 0.49). Studies had small sample sizes and high risk of bias.
Conclusions:
Physical activity reduces symptoms of anxiety in older adults and is an acceptable and promising intervention to incorporate into care planning.
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