The effect of programmed exercise over anxiety symptoms in midlife and older women: a meta-analysis of randomized controlled trials

We aimed to perform a systematic review and meta-analysis in order to clarify the effect of programmed exercise over mild-to-moderate anxiety symptoms (ASs) in midlife and older women. A structured search of PubMed, Medline, Web of Science, Scopus, Embase, Cochrane Library, Scielo, and the US, UK and Australian Clinical Trials databases (from inception through July 27, 2017) was performed, with no language restriction using the following terms: 'anxiety', 'anxiety symptoms', 'exercise', 'physical activity', 'menopause', and 'randomized controlled trial' (RCTs) in mid-aged and older women. We assessed RCTs that compared the effect of exercise for at least 6 weeks versus no intervention over ASs as outcome (as defined by trial authors). Exercise was classified according to duration as 'mid-term exercise intervention' (MTEI; for 12 weeks to 4 months), and 'long-term exercise intervention' (LTEI; for 6-14 months). Mean ± standard deviations of changes for ASs, as assessed with different questionnaires, were extracted to calculate Hedges' g and then used as effect size for meta-analyses. Standardized mean differences (SMDs) of ASs after intervention were pooled using a random-effects model. Ten publications were included for analysis related to 1463 midlife and older women (minimum age 54.2 ± 3.5 and maximum age 77.6 ± 5.4 years). Eight MTEIs were associated with a significant reduction of ASs (SMD = -0.42; 95% CI -0.81 to -0.02) as compared to controls. There was no reduction of ASs in seven LTEIs (SMD = -0.03; 95% CI -0.18 to 0.13). It can be concluded that MTEIs of low-to-moderate intensity seem to improve mild-moderate ASs in midlife and older women.