Structured exercise interventions for reducing anxiety in older adults across settings and health conditions: A systematic review
https://doi.org/10.52235/lp.v7i2.744
Keywords:
Aged, Anxiety, Physical Exercise, Motor Activity, Mental HealthAbstract
Background: Anxiety is a common psychological problem among older adults and is often not optimally managed. Pharmacological treatment may be limited by side effects and tolerability concerns in later life. Structured exercise interventions have been proposed as feasible non-pharmacological approaches, but evidence focused specifically on anxiety reduction across different older adult populations remains fragmented.
Objective: To synthesize evidence on the effectiveness of structured exercise interventions in reducing anxiety among adults aged 60 years and older across different settings and health conditions.
Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. PubMed, ScienceDirect, CrossRef, Scopus, and Google Scholar were searched for studies published from 2015 to 2025, with the final search conducted on April 8, 2026. Randomized controlled trials and quasi-experimental studies involving structured exercise and validated anxiety measures were included. Study quality was appraised using Joanna Briggs Institute (JBI) tools and findings were synthesized narratively.
Results: Eleven studies were included. Most studies reported reductions in anxiety after aerobic exercise, resistance training, multimodal programs, or home-based routines. Effects were reported among healthy/community-dwelling older adults, nursing home residents, and participants with chronic conditions, including those with cancer and Parkinson’s disease. Interventions lasting 6-12 weeks with 2-4 sessions per week were most frequently linked with improved anxiety outcomes. Despite heterogeneity in designs and instruments, results were generally consistent in direction.
Conclusions: Structured exercise interventions are generally associated with reduced anxiety in older adults across multiple settings and health conditions. Further high-quality studies are needed to clarify the most effective exercise prescription and the long-term sustainability of benefits.
Downloads
References
Adasik, D., Bonarska, M., Łocik, G., Szymczyk, S., & Król, K. (2025). Running from depression: a review of aerobic exercise as an adjunctive treatment for mood disorders. Quality in Sport, 40, 59789. https://doi.org/10.12775/qs.2025.40.59789
Aguiñaga, S., Ehlers, D. K., Salerno, E. A., Fanning, J., Motl, R. W., & McAuley, E. (2018). Home-based physical activity program improves depression and anxiety in older adults. Journal of Physical Activity and Health, 15(9), 692–696. https://doi.org/10.1123/jpah.2017-0390
Ardila, N. A., Yuliadarwati, N. M., & Rosidah, N. (2025). Pengaruh kombinasi antara senam aerobic low impact dengan diaphragma breathing exercise terhadap tingkat kecemasan pada lanjut usia di komunitas lansia malang. Jurnal Ilmu Kedokteran Dan Kesehatan, 12(7), 1444–1455.
Atchison, K., Watt, J. A., Ewert, D., Toohey, A. M., Ismail, Z., & Goodarzi, Z. (2022). Non-pharmacologic and pharmacologic treatments for anxiety in long-term care: a systematic review and meta-analysis. Age and Ageing, 51(9), 1–11. https://doi.org/10.1093/ageing/afac195
Babaei Bonab, S., & Parvaneh, M. (2022). The effect of twelve weeks of tai chi exercises on sleep quality, pain perception, and death anxiety in elderly women. Annales Medico-Psychologiques, 180(9), 905–911. https://doi.org/10.1016/j.amp.2022.01.019
Barker, T. H., Habibi, N., Aromataris, E., Stone, J. C., Leonardi-Bee, J., Sears, K., Hasanoff, S., Klugar, M., Tufanaru, C., Moola, S., & Munn, Z. (2024). The revised JBI critical appraisal tool for the assessment of risk of bias for quasi-experimental studies. JBI Evidence Synthesis, 22(3), 378–388. https://doi.org/10.11124/JBIES-23-00268
Barker, T. H., Stone, J. C., Sears, K., Klugar, M., Tufanaru, C., Leonardi-Bee, J., Aromataris, E., & Munn, Z. (2023). The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evidence Synthesis, 21(3), 494–506. https://doi.org/10.11124/JBIES-22-00430
Chalkia, G., Vargi, K., & Bin Husen, A. K. (2025). Effects of Exercise on Quality of Life in Stroke Survivors: A Literature Review. Lentera Perawat, 6(2), 310–317. https://doi.org/10.52235/lp.v6i2.473
Clemente, R., Murphy, A., & Murphy, J. (2024). The relationship between self-reported interoception and anxiety: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews, 167. https://doi.org/10.1016/j.neubiorev.2024.105923
Cunha, P. M., Werneck, A. O., Nunes, J. P., Stubbs, B., Schuch, F. B., Kunevaliki, G., Zou, L., Cyrino, E. S., Cunha, P. M., Werneck, A. O., Nunes, J. P., Stubbs, B., Schuch, F. B., Kunevaliki, G., Zou, L., & Cyrino, E. S. (2021). Resistance training reduces depressive and anxiety symptoms in older women : a pilot study. Aging & Mental Health, 0(0), 1–7. https://doi.org/10.1080/13607863.2021.1922603
Fang, Z., Qian, Y., Sun, S., Qin, H., Zhu, Y., Tang, J., Chen, S., & Luo, Z. (2025). Research progress on the mechanism of exercise against anxiety disorder. Sports Medicine and Health Science. https://doi.org/10.1016/j.smhs.2025.09.005
Fauzika, R. P., Cice Tresnasari, & HJ. R.A. Retno Ekowati. (2023). Tingkat kecemasan dapat mempengaruhi kualitas tidur pada lansia. Bandung Conference Series: Medical Science, 3(1), 240–247. https://doi.org/10.29313/bcsms.v3i1.5936
Ferreira, R. M., Alves, W. M. G. da C., Lima, T. A., Alves, T. G. G., Alves Filho, P. A. M., Pimentel, C. P., Sousa, E. C., & Cortinhas-Alves, E. A. (2018). The effect of resistance training on the anxiety symptoms and quality of life in elderly people with parkinson’s disease: A randomized controlled trial. Arquivos de Neuro-Psiquiatria, 76(8), 499–506. https://doi.org/10.1590/0004-282x20180071
Frost, R., Bauernfreund, Y., & Walters, K. (2019). Non-pharmacological interventions for depression/anxiety in older adults with physical comorbidities affecting functioning: systematic review and meta-analysis. International Psychogeriatrics, 31(8), 1121–1136. https://doi.org/10.1017/S1041610218001564
Galloza, J., Castillo, B., & Micheo, W. (2017). Benefits of Exercise in the Older Population. Physical Medicine and Rehabilitation Clinics of North America, 28(4), 659–669. https://doi.org/10.1016/j.pmr.2017.06.001
Goodarzi, S., Teymouri Athar, M. M., Beiky, M., Fathi, H., Nakhaee, Z., Omran, S. P., & Shafiee, A. (2024). Effect of physical activity for reducing anxiety symptoms in older adults: a meta-analysis of randomized controlled trials. BMC Sports Science, Medicine and Rehabilitation, 16(1). https://doi.org/10.1186/s13102-024-00947-w
Goodarzi, Z., Levy, A. M., Whitmore, C., Chan, T., Mojgani, J., Niculescu, I., Suthakaran, A., Flint, A., Gough, A., Grenier, S., Juola, H., Reynolds, K., Neil-Sztramko, S., Trenaman, S. C., Weir, E., Van Ameringen, M., Yeung, A., & Iaboni, A. (2025). A systematic review and meta-analysis on physical activity for the treatment of anxiety in older adults. International Psychogeriatrics. https://doi.org/10.1016/j.inpsyc.2025.100044
He, J., Liu, F., Xu, P., Xu, T., Yu, H., Wu, B., Wang, H., Chen, J., Zhang, K., Zhang, J., Meng, K., Yan, X., Yang, Q., Zhang, X., Sun, D., & Chen, X. (2024). Aerobic Exercise Improves the Overall Outcome of Type 2 Diabetes Mellitus Among People With Mental Disorders. Depression and Anxiety, 2024(1), 6651804. https://doi.org/10.1155/da/6651804
Hu, S., Tucker, L., Wu, C., & Yang, L. (2020). Beneficial effects of exercise on depression and anxiety during the Covid-19 pandemic: a narrative review. In Frontiers in psychiatry. frontiersin.org. https://doi.org/10.3389/fpsyt.2020.587557
Ibrahim, A. A., Hussein, H. M., Ali, M. S., Kanwal, R., Acar, T., Shaik, D. H., Alghamdi, W., & Althomali, O. W. (2023). A randomized controlled trial examining the impact of low vs. moderate-intensity aerobic training in post-discharge COVID-19 older subjects. European Review for Medical and Pharmacological Sciences, 27(9), 4280–4291. https://doi.org/10.26355/eurrev_202305_32338
Jalali, A., Ziapour, A., Karimi, Z., Rezaei, M., Emami, B., Kalhori, R. P., Khosravi, F., Sameni, J. S., & Kazeminia, M. (2024). Global prevalence of depression, anxiety, and stress in the elderly population: A systematic review and meta-analysis. BMC Geriatrics, 24(1), 809. https://doi.org/10.1186/s12877-024-05311-8
Kandola, A., Vancampfort, D., Herring, M., Rebar, A., Hallgren, M., Firth, J., & Stubbs, B. (2018). Moving to Beat Anxiety: Epidemiology and Therapeutic Issues with Physical Activity for Anxiety. Current Psychiatry Reports, 20(8), 63. https://doi.org/10.1007/s11920-018-0923-x
Kazeminia, M., Salari, N., Raygani, A. V., Jalali, R., & Abdi, A. (2020). The effect of exercise on anxiety in the elderly worldwide : a systematic review and meta ‑ analysis. Health and Quality of Life Outcomes, 1–8. https://doi.org/10.1186/s12955-020-01609-4
Kirk, B., Lombardi, G., & Duque, G. (2025). Bone and muscle crosstalk in ageing and disease. Nature Reviews Endocrinology, 21(6), 375–390. https://doi.org/10.1038/s41574-025-01088-x
Lei, E. F.-C., Wan, K., Dai, Z., & Tam, B. T. (2026). Effectiveness and acceptability of exercise treatments for adults with anxiety disorders: a systematic review and network meta-analysis. BMJ Open Sport & Exercise Medicine, 12(1), e002781. https://doi.org/10.1136/bmjsem-2025-002781
Lewicka, W., Sośniak, I., Szaliński, K., & Szczęsna, E. (2025). The mechanisms of resistance training and its impact on anxiety and depression: a literature review. Journal of Education, Health and Sport, 80(59447), 59447. https://doi.org/10.12775/JEHS.2025.80.59447
Loh, K. P., Kleckner, I. R., Lin, P. J., Mohile, S. G., Canin, B. E., Flannery, M. A., Fung, C., Dunne, R. F., Bautista, J., Culakova, E., Kleckner, A. S., Peppone, L. J., Janelsins, M., McHugh, C., Conlin, A., Cho, J. K., Kasbari, S., Esparaz, B. T., Kuebler, J. P., & Mustian, K. M. (2019). Effects of a Home-based Exercise Program on Anxiety and Mood Disturbances in Older Adults with Cancer Receiving Chemotherapy. Journal of the American Geriatrics Society, 67(5), 1005–1011. https://doi.org/10.1111/jgs.15951
Martínez-Domínguez, S. J., Lajusticia, H., Chedraui, P., & Pérez-López, F. R. (2018). The effect of programmed exercise over anxiety symptoms in midlife and older women: a meta-analysis of randomized controlled trials. Climacteric, 21(2), 123–131. https://doi.org/10.1080/13697137.2017.1415321
Maung, T. M., Jain, T., Madhanagopal, J., Naidu, S. R. L. R., Phyu, H. P., & Oo, W. M. (2022). Impact of Aerobic and Strengthening Exercise on Quality of Life (QOL), Mental Health and Physical Performance of Elderly People Residing at Old Age Homes. Sustainability (Switzerland), 14(17). https://doi.org/10.3390/su141710881
Mikkelsen, M. K., Lund, C. M., Vinther, A., Tolver, A., Johansen, J. S., Chen, I., Ragle, A. M., Zerahn, B., Engell-Noerregaard, L., Larsen, F. O., Theile, S., Nielsen, D. L., & Jarden, M. (2022). Effects of a 12-Week Multimodal Exercise Intervention Among Older Patients with Advanced Cancer: Results from a Randomized Controlled Trial. Oncologist, 27(1), 67–78. https://doi.org/10.1002/onco.13970
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Peng, X., Menhas, R., Dai, J., & Younas, M. (2022). The COVID-19 pandemic and overall wellbeing: Mediating role of virtual reality fitness for physical-psychological health and physical activity. Psychology Research and Behavior Management, Volume 15, 1741–1756. https://doi.org/10.2147/PRBM.S369020
Porserud, A., Aly, M., Steinertz, H., Rydwik, E., & Hagströmer, M. (2024). Exercise in primary care after robot-assisted radical cystectomy for urinary bladder cancer – effects on postoperative complications: a secondary analysis of a randomised controlled trial. Scandinavian Journal of Urology, 59, 193–199. https://doi.org/10.2340/sju.v59.42589
Putri, V. D., Apriyanti, P., & Aini, A. (2025). The Effect of Lavender Aromatherapy on Reducing Anxiety in Primigravida Mothers during Kala I Latent Phase: A Pra-experimental Study. Lentera Perawat, 6(2), 296–301. https://doi.org/10.52235/lp.v6i2.454
Qiu, Y., Fernández-García, B., Lehmann, H. I., Li, G., Kroemer, G., López-Otín, C., & Xiao, J. (2023). Exercise sustains the hallmarks of health. Journal of Sport and Health Science, 12(1), 8–35. https://doi.org/10.1016/j.jshs.2022.10.003
Rezola-Pardo, C., Arrieta, H., Gil, S. M., Zarrazquin, I., Yanguas, J. J., López, M. A., Irazusta, J., & Rodriguez-Larrad, A. (2019). Comparison between multicomponent and simultaneous dual-task exercise interventions in long-term nursing home residents: the Ageing-ONDUAL-TASK randomized controlled study. Age and Ageing, 48(6), 817–823. https://doi.org/10.1093/ageing/afz105
Ruiz-Comellas, A., Valmaña, G. S., Catalina, Q. M., Baena, I. G., Mendioroz Peña, J., Roura Poch, P., Sabata Carrera, A., Cornet Pujol, I., Casaldàliga Solà, À., Fusté Gamisans, M., Saldaña Vila, C., Vázquez Abanades, L., & Vidal-Alaball, J. (2022). Effects of Physical Activity Interventions in the Elderly with Anxiety, Depression, and Low Social Support: A Clinical Multicentre Randomised Trial. Healthcare (Switzerland), 10(11), 2203. https://doi.org/10.3390/healthcare10112203
Ruiz-Gonzalez, D., Herandez-Martínez, A., Valenzuela, P. L., Morales, J. S., & Soriano-Maldonado, A. (2021). Effects of physical exercise on plasma brain-derived neurotrophic factor in neurodegenerative disorders: A systematic review and meta-analysis of randomized controlled trials. Neuroscience and Biobehavioral Reviews, 128, 394–405. https://doi.org/10.1016/j.neubiorev.2021.05.025
Sampedro-Piquero, P., & Moreno-Fernández, R. D. (2021). Building Resilience with Aerobic Exercise : Role of FKBP5. Current Neuropharmacology, 19(8), 1156–1160. https://doi.org/10.2174/1570159X19666210408124937
Silva, Dendasck, W. C. da, Oliveira, C., & De., E. (2023). Psychophysiological Contributions of Resistance Training (RT) for The Treatment of Anxiety Disorders in Young Adults. Revista Científica Multidisciplinar Núcleo Do Conhecimento, 110–124. https://doi.org/10.32749/nucleodoconhecimento.com.br/education/psychophysiological-contributions
Stein, A. M., Silva, T. M. V. da, Coelho, F. G. de M., Rueda, A. V. R. C., & Galdur´oz, R. F. S. (2021). Acute exercise increases circulating IGF-1 in Alzheimer’s disease patients, but not in older adults without dementia. Behavioural Brain Research, 396. https://doi.org/10.1016/j.bbr.2020.112903
Tao, M., Li, S., Li, L., Cao, Y., & Zhuang, J. (2025). Impact of physical exercise on health and social interaction in older adults: a meta-analysis. Frontiers in Public Health, 13. https://doi.org/10.3389/fpubh.2025.1634313
Ten, J., Jung, K., Souza, L., Vanessa, M., Zborowski, A., & Lutz, G. (2022). Resistance Training Modulates Hippocampal Neuroinflammation and Protects Anxiety ‑ Depression ‑ like Dyad Induced by an Emotional Single Prolonged Stress Model. Molecular Neurobiology, 2019(0123456789). https://doi.org/10.1007/s12035-022-03069-x
Thivel, D., Tremblay, A., Genin, P. M., & Panahi, S. (2018). Physical Activity, Inactivity, and Sedentary Behaviors : Definitions and Implications in Occupational Health. Front. Public Health, 6(288), 1–5. https://doi.org/10.3389/fpubh.2018.00288
Tri Maghfuroh, P. N., Marupa, W. R., Yuliadarwati, N. M., & Prastowo, B. (2024). Pengaruh Senam Triloka Terhadap Ringkat Kecemasan Lansia di Griya Lansia Husnul Khatimah. Jurnal Kesehatan Holistic, 8(1), 26–35. https://doi.org/10.33377/jkh.v8i1.183
Umegaki, H., Sakurai, T., & Arai, H. (2021). Active Life for Brain Health: A Narrative Review of the Mechanism Underlying the Protective Effects of Physical Activity on the Brain. Front. Aging Neurosci, 13(761674), 1–11. https://doi.org/10.3389/fnagi.2021.761674
World Health Organization. (2024). Ageing and Health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
Wulansari, Margawati, A., & Hadi W, R. (2018). Effect of brain exercise and Benson relaxation therapy on depression level in the elderly social service unit. Belitung Nursing Journal, 4(2), 211–218. https://doi.org/10.33546/bnj.361
Yanti S, N., Ashra, F., Apriadi, D., Junios, J., Putra, Y., & Liza, F. (2026). Effect of finger-holding technique on pain and anxiety in patients after Transurethral Resection of the Prostate (TURP): A quasi-experimental study. Lentera Perawat, 7(1), 251–259. https://doi.org/10.52235/lp.v7i1.719
Zhou, Y. S., Meng, F. C., Cui, Y., Xiong, Y. L., Li, X. Y., Meng, F. B., Niu, Z. X., Zheng, J. X., Quan, Y. Q., Wu, S. X., Han, Y., & Xu, H. (2022). Regular Aerobic Exercise Attenuates Pain and Anxiety in Mice by Restoring Serotonin-Modulated Synaptic Plasticity in the Anterior Cingulate Cortex. Medicine and Science in Sports and Exercise, 54(4), 566–581. https://doi.org/10.1249/MSS.0000000000002841
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Anisa Rizki Fadhilah, Aditya Denny Pratama

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.




