Structured exercise interventions for reducing anxiety in older adults across settings and health conditions: A systematic review

Abstrak

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.