Long-Term Effects of Cognitive-Behavioral Therapy and Yoga for Worried Older Adults

Suzanne C Danhauer; Michael E Miller; Jasmin Divers; Andrea Anderson; Gena Hargis; Gretchen A Brenes

doi:10.1016/j.jagp.2022.02.002

Long-Term Effects of Cognitive-Behavioral Therapy and Yoga for Worried Older Adults

Am J Geriatr Psychiatry. 2022 Sep;30(9):979-990. doi: 10.1016/j.jagp.2022.02.002. Epub 2022 Feb 6.

Authors

Suzanne C Danhauer¹, Michael E Miller², Jasmin Divers³, Andrea Anderson⁴, Gena Hargis⁵, Gretchen A Brenes⁶

Affiliations

¹ Department of Social Sciences and Health Policy (SCD), Wake Forest School of Medicine, Winston Salem, NC. Electronic address: danhauer@wakehealth.edu.
² Department of Biostatistics and Data Science (MEM), Wake Forest School of Medicine, Winston Salem, NC.
³ Division of Health Services Research (JD), NYU Long Island School of Medicine, New York, NY.
⁴ Department of Biostatistics and Data Science (AA), Wake Forest School of Medicine, Winston Salem, NC.
⁵ Department of Internal Medicine (GH), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC.
⁶ Department of Internal Medicine (GAB), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC.

PMID: 35260292
DOI: 10.1016/j.jagp.2022.02.002

Abstract

Objectives: Cognitive-behavioral therapy (CBT) and yoga decrease worry and anxiety. There are no long-term data comparing CBT and yoga for worry, anxiety, and sleep in older adults. The impact of preference and selection on these outcomes is unknown. In this secondary data analysis, we compared long-term effects of CBT by telephone and yoga on worry, anxiety, sleep, depressive symptoms, fatigue, physical function, social participation, and pain; and examined preference and selection effects.

Design: In this randomized preference trial, participants (N = 500) were randomized to a: 1) randomized controlled trial (RCT) of CBT or yoga (n = 250); or 2) preference trial (selected CBT or yoga; n = 250). Outcomes were measured at baseline and Week 37.

Setting: Community.

Participants: Community-dwelling older adults (age 60+ years).

Interventions: CBT (by telephone) and yoga (in-person group classes).

Measurements: Penn State Worry Questionnaire - Abbreviated (worry);¹^,² Insomnia Severity Index (sleep);³ PROMIS Anxiety Short Form v1.0 (anxiety);⁴^,⁵ Generalized Anxiety Disorder Screener (generalized anxiety);⁶^,⁷ and PROMIS-29 (depression, fatigue, physical function, social participation, pain).⁸^,⁹ RESULTS: Six months after intervention completion, CBT and yoga RCT participants reported sustained improvements from baseline in worry, anxiety, sleep, depressive symptoms, fatigue, and social participation (no significant between-group differences). Using data combined from the randomized and preference trials, there were no significant preference or selection effects. Long-term intervention effects were observed at clinically meaningful levels for most of the study outcomes.

Conclusions: CBT and yoga both demonstrated maintained improvements from baseline on multiple outcomes six months after intervention completion in a large sample of older adults.

Trial registration: www.

Clinicaltrials: gov Identifier NCT02968238.

Keywords: Cognitive-behavioral therapy; aged; anxiety; humans; long-term effects; sleep; telephone; worry; yoga.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Anxiety / therapy
Cognitive Behavioral Therapy*
Fatigue / complications
Humans
Pain
Treatment Outcome
Yoga*

Associated data

ClinicalTrials.gov/NCT02968238