. 2023 Jul 19;17(1):25.

doi: 10.1186/s13030-023-00280-7.

Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial

Kristine Sirevåg^{1

2}, S H Stavestrand^{3

4}, T Sjøbø³, T B Endal³, H M Nordahl⁵, E Andersson^{6

7}, I H Nordhus^{4

8}, Å Rekdal³, K Specht^{9

10}, Å Hammar^{10

11}, A Halmøy^{12

13}, J Mohlman¹⁴, H Hjelmervik¹⁵, J F Thayer¹⁶, A Hovland^{3

4}

Affiliations

¹ Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway. kristine.sirevag@solli.no.
² Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway. kristine.sirevag@solli.no.
³ Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway.
⁴ Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway.
⁵ Department of Mental Health, Norwegian University of Science and Technology, Trondheim, NO-7030, Norway.
⁶ The Swedish School of Sport and Health Sciences, GIH, Stockholm, 5626 SE-114 86, box, Sweden.
⁷ Department of Neuroscience, Karolinska Institutet, Stockholm, 171 177, Sweden.
⁸ Faculty of Medicine, University of Oslo, P.O. Box 1078, Blindern, Oslo, NO-0316, Norway.
⁹ Faculty of humanities, social sciences and education, UiT The Arctic University of Norway, Tromsø, Norway.
¹⁰ Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7807, Bergen, NO- 5020, Norway.
¹¹ Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
¹² Department of Psychiatry, Haukeland University Hospital, Kronstad DPS, P.O. Box 1400, Bergen, NO- 5021, Norway.
¹³ Department of Clinical Medicine, University of Bergen, P.O. Box 7804, Bergen, NO-5020, Norway.
¹⁴ Department of Psychology, William Paterson University, 300 Pomton Road, Wayne, NJ, 07470, USA.
¹⁵ School of Health Sciences, Kristiania University College, Kalfarveien 78c, Bergen, 5022, Norway.
¹⁶ Department of Psychological Science, The University of California, Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA.

PMID: 37468978
PMCID: PMC10357630
DOI: 10.1186/s13030-023-00280-7

Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial

Kristine Sirevåg et al. Biopsychosoc Med. 2023.

. 2023 Jul 19;17(1):25.

doi: 10.1186/s13030-023-00280-7.

Authors

Affiliations

¹ Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway. kristine.sirevag@solli.no.
² Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway. kristine.sirevag@solli.no.
³ Solli DPS, Osvegen 15 Nesttun, 5228, Bergen, Norway.
⁴ Department of Clinical Psychology, University of Bergen, P.O. Box 7800, Bergen, NO-5020, Norway.
⁵ Department of Mental Health, Norwegian University of Science and Technology, Trondheim, NO-7030, Norway.
⁶ The Swedish School of Sport and Health Sciences, GIH, Stockholm, 5626 SE-114 86, box, Sweden.
⁷ Department of Neuroscience, Karolinska Institutet, Stockholm, 171 177, Sweden.
⁸ Faculty of Medicine, University of Oslo, P.O. Box 1078, Blindern, Oslo, NO-0316, Norway.
⁹ Faculty of humanities, social sciences and education, UiT The Arctic University of Norway, Tromsø, Norway.
¹⁰ Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7807, Bergen, NO- 5020, Norway.
¹¹ Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
¹² Department of Psychiatry, Haukeland University Hospital, Kronstad DPS, P.O. Box 1400, Bergen, NO- 5021, Norway.
¹³ Department of Clinical Medicine, University of Bergen, P.O. Box 7804, Bergen, NO-5020, Norway.
¹⁴ Department of Psychology, William Paterson University, 300 Pomton Road, Wayne, NJ, 07470, USA.
¹⁵ School of Health Sciences, Kristiania University College, Kalfarveien 78c, Bergen, 5022, Norway.
¹⁶ Department of Psychological Science, The University of California, Irvine, 4201 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA.

PMID: 37468978
PMCID: PMC10357630
DOI: 10.1186/s13030-023-00280-7

Erratum in

Correction to: Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial.
Sirevåg K, Stavestrand SH, Sjøbø T, Endal TB, Nordahl HM, Andersson E, Nordhus IH, Rekdal Å, Specht K, Hammar Å, Halmøy A, Mohlman J, Hjelmervik H, Thayer JF, Hovland A. Sirevåg K, et al. Biopsychosoc Med. 2023 Aug 4;17(1):28. doi: 10.1186/s13030-023-00284-3. Biopsychosoc Med. 2023. PMID: 37542338 Free PMC article. No abstract available.

Abstract

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 .

Keywords: CBT; Cognitive behaviour therapy; Feasibility study; GAD; Generalised anxiety disorder; Older adults; Physical exercise.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

**Fig. 1**
Feasibility study design Note. * DNA sampled only at pre-treatment testing. ** Actiwatch, MRI and neuropsychological tests not administered at Interim testing

**Fig. 3**
Feasibility CONSORT Flow Diagram

See this image and copyright information in PMC

Cited by

Correction to: Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial.
Sirevåg K, Stavestrand SH, Sjøbø T, Endal TB, Nordahl HM, Andersson E, Nordhus IH, Rekdal Å, Specht K, Hammar Å, Halmøy A, Mohlman J, Hjelmervik H, Thayer JF, Hovland A. Sirevåg K, et al. Biopsychosoc Med. 2023 Aug 4;17(1):28. doi: 10.1186/s13030-023-00284-3. Biopsychosoc Med. 2023. PMID: 37542338 Free PMC article. No abstract available.

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1. Hall J, Kellett S, Berrios R, Bains MK, Scott S. Efficacy of cognitive behavioral therapy for generalized anxiety disorder in older adults: systematic review, meta analysis, and meta-regression. Am J Geriatric Psychiatry. 2016;24(11):1063–73. - PubMed
1. Wolitzky-Taylor KB, Castriotta N, Lenze EJ, Stanley MA, Craske MG. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety. 2010;27(2):190–211. - PubMed
1. Kishita N, Laidlaw K. Cognitive behaviour therapy for generalized anxiety disorder: is CBT equally efficacious in adults of working age and older adults? Clin Psychol Rev. 2017;52:124–36. - PubMed

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Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial

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Physical exercise augmented cognitive behaviour therapy for older adults with generalised anxiety disorder (PEXACOG): a feasibility study for a randomized controlled trial

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