Older adults have low levels of mental health literacy relating to anxiety which may contribute to delaying or not seeking help. Lifestyle interventions, including physical activity (PA), have increasing evidence supporting their effectiveness in reducing anxiety. The COVID-19 pandemic also highlighted the potential for technology to facilitate healthcare provision. This study aimed to investigate perspectives of older adults about their understanding of anxiety, possible use of PA interventions to reduce anxiety, and whether technology could help this process.

The INDIGO trial evaluated a PA intervention for participants aged 60 years and above at risk of cognitive decline and not meeting PA guidelines. Twenty-nine of the INDIGO trial completers, including some with anxiety and/or cognitive symptoms, attended this long-term follow-up study including semi-structured qualitative interviews. Transcripts were analyzed thematically.

There was quite a diverse understanding of anxiety amongst participants. Some participants were able to describe anxiety as involving worry, uncertainty and fear, as well as relating it to physical manifestations and feeling out of control. Others had less understanding of the concept of anxiety or found it confusing. Participants generally believed that PA could potentially reduce anxiety and thought that this could occur through a “mindfulness” and/or “physiological” process. Technology use was a more controversial topic with some participants quite clearly expressing a dislike or distrust of technology or else limited access or literacy in relation to technology. Participants who were supportive of using technology described that it could help with motivation, information provision and health monitoring. Wearable activity monitors were described favorably, with online platforms and portable devices also being options.

Our results highlight the importance of increasing information and education about anxiety to older adults. This may increase awareness of anxiety and reduce delays in seeking help or not seeking help at all. Findings also emphasize the need for clinicians to support understanding of anxiety in older adults that they are seeing and provide information and education where needed. It is likely that PA interventions to reduce anxiety, with the option of a technology component with support, will be acceptable to most older adults.

Recent evidence suggests that exercise plays a role in cognition and that the posterior cingulate cortex (PCC) can be divided into dorsal and ventral subregions based on distinct connectivity patterns.

To examine the effect of physical activity and division of the PCC on brain functional connectivity measures in subjective memory complainers (SMC) carrying the epsilon 4 allele of apolipoprotein E (APOE 4) allele.

Participants were 22 SMC carrying the APOE ɛ4 allele (ɛ4+; mean age 72.18 years) and 58 SMC non-carriers (ɛ4–; mean age 72.79 years). Connectivity of four dorsal and ventral seeds was examined. Relationships between PCC connectivity and physical activity measures were explored.

ɛ4+ individuals showed increased connectivity between the dorsal PCC and dorsolateral prefrontal cortex, and the ventral PCC and supplementary motor area (SMA). Greater levels of physical activity correlated with the magnitude of ventral PCC–SMA connectivity.

The results provide the first evidence that ɛ4+ individuals at increased risk of cognitive decline show distinct alterations in dorsal and ventral PCC functional connectivity.