Exercise improves anxiety and mood in older adults undergoing chemotherapy

Although we know that exercise improves anxiety and mood problems in younger people with cancer, few studies have looked at the effects of exercise on older adults with cancer. Since most new cancer cases occur in adults aged 60 or older, a team of researchers from the University of Rochester Medical Center and other institutions designed a study to learn more.

Their study appeared in the June issue of the Journal of the American Geriatrics Society (JAGS).

Having cancer increases the chances of people experiencing anxiety and mood issues, which can affect emotional and social well-being. In turn, this may lead people to discontinue cancer treatments--which can mean shortening their survival.

Chemotherapy can benefit older adults with cancer, even though older people receiving this type of treatment often experience higher rates of dangerous side effects than younger people do. Older adults often experience anxiety and other mood disorders during their treatment for cancer, too--and treating those problems with medications can often cause potentially dangerous side effects.

What's more, many anti-anxiety medications such as benzodiazepines and antidepressants are listed in the American Geriatrics Society (AGS) Beers Criteria® as being potentially inappropriate for older adults. That's why it is desirable to seek alternative treatments that are safe and effective at improving anxiety, mood disturbances, and emotional and social well-being, including treatments that don't rely on medications. For example, several studies have been conducted to examine the relationship between exercise and mood in cancer survivors and most have shown positive results.

The researchers in the new JAGS study examined the Exercise for Cancer Patients (EXCAP) program, a home-based, low- to moderate-intensity aerobic and resistance exercise program. In the study, those who were assigned to the EXCAP program received an exercise kit. It contained a pedometer, three exercise bands (medium, heavy, extra heavy), and an instruction manual.

During the program, participants increased the length and intensity of their workouts over time. For example, participants received an individually tailored, progressive walking routine, and they wore a pedometer and recorded their daily steps over six weeks, starting on their first day of chemotherapy treatment. They were encouraged to gradually increase their steps by five to 20 percent every week. For resistance exercise, they performed exercises with therapeutic exercise bands. Participants were given individually-tailored workout plans that encouraged them to perform 10 required exercises (such as squats and chest presses) and four optional exercises daily. Participants were also encouraged to increase the intensity and number of repetitions of resistance band exercises gradually over the course of the program.

The researchers concluded that a low- to moderate-intensity home-based exercise program improved anxiety, mood, and social and emotional well-being for older patients with cancer who received chemotherapy treatments.

The researchers also noted that in the study, the people who benefited the most from the exercise program were older adults who received chemotherapy and started off with worse anxiety, mood, and social and emotional well-being.

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This summary is from "Effects of a home-based exercise program on anxiety and mood disturbances in older adults with cancer receiving chemotherapy." It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Kah Poh Loh, MBBCh, BAO; Ian R. Kleckner, PhD, MPH; Po-Ju Lin, PhD, MPH, RD; Supriya G. Mohile, MD, MS; Beverly E. Canin; Marie A. Flannery, PhD, RN, AOCN; Chunkit Fung, MD, MSCE; Richard F. Dunne, MD; Javier Bautista, MD, MPH; Eva Culakova, PhD, MS; Amber S. Kleckner, PhD; Luke J. Peppone, PhD, MPH; Michelle Janelsins, PhD, MPH; Colin McHugh, MD; Alison Conlin, MD, MPH; Jonathan K. Cho, MD; Sameer Kasbari, MD; Benjamin T. Esparaz, MD, FACP; J. Philip Kuebler, MD; and Karen M. Mustian, PhD, MPH.

This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.

Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has--for 75 years--worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.