Sirevåg Kristine, Stavestrand S H, Sjøbø T, Endal T B, Nordahl H M, Andersson E, Nordhus I H, Rekdal Å, Specht K, Hammar Å, Halmøy A, Mohlman J, Hjelmervik H, Thayer J F, Hovland A
Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway.
Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway.
Biopsychosoc Med. 2023 Jul 19;17(1):25. doi: 10.1186/s13030-023-00280-7.
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.
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.
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.
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.
ClinicalTrials.gov, NCT02690441. Registered on 24 February 2016, https://clinicaltrials.gov/ct2/show/NCT02690441 .
广泛性焦虑障碍（GAD）在老年人中是一种常见且严重的疾病。对于患有GAD的老年人，推荐的治疗方法认知行为疗法（CBT）的效果会降低。体育锻炼（PE）可能通过改善认知功能和提高脑源性神经营养因子（BDNF）水平来增强CBT的效果，BDNF是焦虑症患者CBT效果的一个预测指标。本研究的目的是评估一项随机对照试验（RCT）的可行性，该试验旨在调查CBT与PE联合治疗对老年GAD患者样本的治疗效果，包括评估和治疗程序。
纳入了4名年龄在62 - 70岁（M = 65.5，SD = 3.2）、初步诊断为GAD的参与者。参与者接受了15周的体育锻炼并结合10周的认知行为疗法。参与者在治疗前、中期和后期完成了自我报告测量以及临床、生物学、生理学和神经心理学测试。
呈现了程序、方案和结果。一名参与者在治疗期间退出。对于完成治疗的三名参与者，体育锻炼和认知行为疗法的总依从率分别为80%和100%。一名独立评估者得出结论，完成治疗的参与者在治疗后不再符合GAD的标准。自我报告测量的变化表明与焦虑和担忧相关的症状有所减轻。该样本被认为代表了目标人群。
结果表明，将CBT与PE联合用于老年GAD患者是可行的，并且这些程序和测试对于当前样本是合适且可管理的。
ClinicalTrials.gov，NCT02690441。于2016年2月24日注册，https://clinicaltrials.gov/ct2/show/NCT02690441 。
