Anxiety disorders are the most prevalent psychiatric disorders. Among older adults, anxiety is more common that depression, yet research on the nature and treatment of anxiety has lagged far behind that of depression. There are very few comparative effectiveness trials for treating late-life anxiety. Thus, clinicians are unable to provide an informed recommendation of one treatment over the other.
Research has demonstrated that Cognitive-behavioral therapy (CBT) is superior to enhanced usual care as well as supportive therapy in improving worry, depressive symptoms, and sleep, and these improvements are maintained for up to 1 year upon completing treatment.
Research also demonstrates that yoga reduces anxiety symptoms and improves sleep.
However, no one has conducted a comparative effectiveness trial of CBT and yoga for treating worry in older adults.
In this study, the investigators had a 500 person two-stage randomized preference trial comparing 1) wekkely cognitive-behavioral therapy with 2) bi-weekly yoga for the treatment of worry in a sample of older adults. Participants were randomized to either the preference group (participants choose the treatment) or to the random group (participants are randomized to 1 of the 2 treatments). This study design allows for the calculation of traditional treatment effects (differences in outcomes between participants randomized to either CBT or yoga), selection effects (differences in outcomes between participants who choose CBT and those who choose yoga), and preference effects (differences in outcomes between participants who choose their treatment and those who are randomized to treatment).
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.
CBT and yoga both equally demonstrated maintained improvements from baseline on multiple outcomes six months after intervention completion in a large sample of older adults. These findings show that both interventions can have long-term impact for treating worry in older adults.