A randomized preference trial of cognitive-behavioral therapy and yoga for the treatment of worry in anxious older adults

Abstract

BackgroundWorry is a common problem among older adults. Cognitive-behavioral therapy is the most studied nonpharmacological intervention and it has demonstrated efficacy in reducing late-life worry and anxiety. Although the evidence-base is smaller, yoga has been shown to reduce anxiety and stress. However, little is known about the relative effectiveness of these two nonpharmacological interventions. Further, the impact of patient preference on outcomes is unknown.Purpose: The purpose to this study is to compare the effectiveness of cognitive-behavioral therapy (CBT) with yoga for improving late-life worry, anxiety, and sleep. We will also examine the effects of preference and selection on outcomes, adherence, and attrition.MethodsWe are conducting a two-stage randomized preference trial comparing CBT and yoga for the reduction of worry in a sample of anxious older adults. Five hundred participants will be randomized to either the preference trial (participants choose the intervention; N = 250) or to the randomized trial (participants are randomized to one of the two interventions; N = 250) with equal probability. CBT consists of 10 telephone-based sessions with an accompanying workbook. Yoga consists of 10 weeks of group yoga classes (twice a week) that is modified for use with older adults.ConclusionsThe study design is based on feedback from anxious older adults who wanted more nonpharmacological options for intervention as well as more input into the intervention they receive. It is the first head-to-head comparison of CBT and yoga for reducing late-life worry and anxiety. It will also provide information about how intervention preference affects outcomes.Trial registrationClinicalTrials.gov NCT02968238.

Leisure Motivation and Satisfaction: A Text Mining of Yoga Centres, Yoga Consumers, and Their Interactions

“…Hoyez [68] proposed a yoga site as a place adjusted for urban residents' need for a small island of peace and serenity in the midst of urban life. Because yoga was proven to reduce anxiety [5,6], it is not surprising that yogis wish to enhance its tranquillising function by temporarily isolating themselves. As one yogi wrote, "Yoga is associated with quietness and comfort.…”

“…Yoga was long studied primarily as a medical therapy that treats physical pain [1,2] and illness [3,4], as well as mental anxiety [5,6] and depression [7,8], enhancing the sustainability of personal lives in terms of both physical wellness and mental happiness. However, yoga is seldom investigated as a leisure service or business [9][10][11][12], which affects the sustainability of consumers' personal lives by fulfilling their motivation and triggering their satisfaction [13][14][15][16].…”

Comparison of cognitive‐behavioral therapy and yoga for the treatment of late‐life worry: A randomized preference trial

“…Study procedures have been described in detail elsewhere (Brenes et al, 2018). Participants were recruited through outpatient clinics, flyers, mailings, and newspaper advertisements.…”

“…All study assessments [described in detail elsewhere; (Brenes et al, 2018)] were self-report and were completed by telephone, in person, or by mail. Analyses of data collected at baseline (Week 0; demographic/health-related information, primary outcome, secondary outcomes); primary and secondary outcomes assessed at intervention midpoint (Week 6); and primary and secondary outcomes assessed upon intervention completion (Week 11) are presented here.…”

“…The workbook instructed participants in techniques for managing worry and anxiety. Each session focused on a weekly assigned chapter with standard CBT topics (e.g., relaxation techniques, cognitive restructuring) (Brenes et al, 2018) Yoga was provided by seven yoga instructors with at least RYT…”