Effects of yoga-related mind-body therapies on cognitive function in older adults: A systematic review with meta-analysis

Yoga-A complementary and traditional medicine for human health

Yoga is a therapeutic practice renowned for its multifaceted benefits across the body's systems. Its positive impact spans the physical, mental and emotional realms, fostering harmony and well-being. Through a combination of postures, breathing techniques and meditation, yoga offers profound effects, enhancing flexibility, strength and balance while simultaneously promoting relaxation and reducing stress. This integrative approach not only cultivates physical resilience but also supports mental clarity, emotional balance and overall vitality, showcasing yoga as a comprehensive and impactful system for holistic health. The review delved into the multifaceted ways in which yoga exerts a positive influence on the body's various systems. It highlights how yoga serves as a beneficial tool in addressing and counteracting the underlying factors associated with different diseases. By examining yoga's effects on these systems and its potential in combating illness, the paper sheds light on the comprehensive therapeutic benefits that yoga offers. Please cite this article as: Pandey S, Pandey AC, Kotecha VR. Yoga-A complementary and traditional medicine for human health. J Integr Med. 2025; 23(2): 93-105.

Yoga-based lifestyle intervention for healthy ageing in older adults: a two-armed, waitlist randomized controlled trial with multiple primary outcomes

Yoga-based clinical research has shown considerable promise in varied ageing-related health outcomes in older adults. However, robust frameworks have yet to be used in intervention research to endorse yoga as a healthy ageing intervention to test the multidimensional construct of healthy ageing. This was an assessor-masked, randomized controlled trial conducted among 258 sedentary, community-dwelling older adults aged 60-80 years, randomly allocated to 26-week yoga-based intervention (YBI) (n = 132) or waitlist control (WLC) (n = 126). The effectiveness of YBI was assessed through two separate global statistical tests, generalized estimating equations and rank sum-based test, against a comprehensive healthy aging panel comprised of ten markers representing the domains of physiological and metabolic, cognitive, physical capability, psychological, and social well-being. The secondary outcomes were individual primary marker scores, Klotho, inflammatory markers, and auxiliary blood markers. We could establish the healthy aging effect of the 26-week YBI over WLC using two models of global statistical test (GEE, β = 0.29; 95% CI = 0.20 to 0.38, p < 0.001), and rank sum-based test (β = 0.28, 95% CI = 0.19 to 0.36, p < 0.001). There were also significant improvements in direction of benefit at individual levels of all the aging markers. Exploratory evaluation with adopted indices from contemporary clinical trials also validated the potential of YBI for healthy aging; HATICE adapted composite score (mean difference =  - 0.18; 95% CI =  - 0.26 to - 0.09, p < 0.001) and healthy ageing index (mean difference =  - 0.33; 95% CI =  - 0.63 to - 0.02, p = 0.03). The global effect of YBI across multiple ageing-related outcomes provides a proof of concept for further large-scale validation. The findings hold a great translational value given the accelerated pace of population aging across the globe. Trial registration: CTRI/2021/02/031373.

Reduced Anxiety and Depression and Improved Mood in Older Adults Living in Care Homes After Participating in Chair Yoga

Providing opportunities for older adults to engage in physical and mental activity is important to support healthy aging. The present preliminary study investigated the feasibility of accessible chair yoga for older adults in care homes. Chair yoga participants (n = 17) were assessed before and after attending twice weekly chair yoga sessions for 8 weeks, while control participants (n = 16) underwent the assessments only. Participant ages ranged from 80 to 101 years and included those living with mild to severe dementia. Anxiety and depression measured by the Hospital Anxiety and Depression Scale (HADS), and negative affect measured by the Positive and Negative Affect Schedule (PANAS), improved in the chair yoga but not the control group. Balance confidence (Modified Falls Efficacy Scale) and Health-related Quality of Life (EQ-5D-3L) were unchanged. Chair yoga is a feasible activity for older care home residents, including those living with dementia, with the potential to improve mental well-being.

What exercise strategies are best for people with cognitive impairment and dementia? A systematic review and meta-analysis

OBJECTIVE

Explore the types of exercise that are appropriate for people with dementia, as well as the intensity and frequency of exercise training that is appropriate for older patients to carry out.

METHODS

Cochrane Library, PubMed, Embase, Web of Science, Scopus databases were searched by computer to collect RCT studies that met the inclusion criteria of this article. The search time limit was until January 2024. Two reviewers independently screened literature, extracted data, and assessed the quality and risk of bias of the included studies. Then, meta-analysis was performed using RevMan 5.4 and Stata 15.1 software.

RESULTS

The results of our study showed that physical exercise improved patients' cognitive ability and walking ability, with aerobic and multicomponent training showing the best improvement, and that the number of training sessions should not be too high, with the experimental group showing the best results when the total number of interventions was less than 30.

CONCLUSION

We recommend long-term exercise training for middle-aged and elderly patients with dementia or those who are predisposed to dementia. The type of training we recommend is multi-component training and aerobic training, and we recommend 2-3 sessions of exercise per week for about 60 min each.

Navigating Prevention: A Systematic Review of Strategies for Alzheimer's Disease in High-Risk and Affected Individuals

Alzheimer's disease (AD) remains a widespread cause of dementia globally, and its prevalence is increasing due to the aging population. Two key pathologies typically identify this neurodegenerative disease process: the accumulation of amyloid plaques and the formation of neurofibrillary tangles containing hyperphosphorylated tau. Diagnosis relies on the patient's clinical presentation meeting specific criteria, along with the use of fluid and imaging biomarkers. The current treatment focuses on addressing symptoms, with ongoing trials aiming to decrease the production and overall impact of brain pathology. Here, we explore various methods to minimize the risks of AD in patients and individuals at high risk of developing it. To address this, we carefully selected 10 articles that discuss various prevention methods used today to promote brain health, including diets that are believed to have neuroprotective properties. The study findings emphasize the importance of further strengthening the evidence and conducting larger randomized controlled trials to gain a better understanding of the potential benefits for individuals at high risk of developing AD, as well as those already diagnosed with it.

Selecting an appropriate control group for studying the effects of exercise on cognitive performance

Differences in expectations between experimental and control groups can influence the outcomes of exercise interventions, emphasizing the need to match expectations across study groups. This online study examined whether the expectations to improve the performance of different cognitive tasks differ between various activities commonly used in research on the effects of exercise and cognitive function. Two hundred and five middle-aged adults performed two reaction-time tasks and one memory task. They were then asked to rate, on a 1-5 Likert scale, their expectations to improve performance in those tasks should they engage in six types of activities for three months: brisk walking, resistance exercise, stretching and balance exercises, watching videos with lectures on art, history, and science, a program of relaxation techniques, and yoga/tai chi/meditation. Results revealed that the highest expectations for improvement were associated with relaxation techniques and yoga/tai chi/meditation. Some activities, such as brisk walking and stretch and balance exercises, shared similar expectations. Previous knowledge of the possible beneficial effects of exercise on cognitive performance also led to higher expectations. To establish causal relationships, researchers should strive to use activities that share similar expectations to improve performance for the experimental and control groups. The findings of this study provide such activity pairs. Finally, researchers should also try to match participants with and without prior knowledge of the benefits of exercise to cognitive function between experimental and control groups.

The impact of yoga on aging physiology: A review

Frailty represents diminished reserve across multiple physiologic systems, accompanied by increased vulnerability to stressors and increased morbidity and mortality. With population aging, strategies to prevent and manage frailty are priorities in clinical medicine and public health. Current evidence-based approaches to frailty management are multimodal in nature. Yoga, an increasingly popular and highly adaptable mind-body practice, is multi-component, incorporating physical postures, breathing practices, meditation, and other elements, and may be a strategy for frailty management. Here, we summarize the evidence linking yoga practice to mitigation of age-related degradation across multiple physiologic systems, including cardiovascular, pulmonary, musculoskeletal, and nervous systems. We discuss putative mechanisms of action including modulation of the hypothalamic-pituitary-adrenal axis. Finally, we consider implications for clinical practice and future research.

Holistic frailty prevention: The promise of movement-based mind-body therapies

Aging is characterized by fundamental cellular and molecular hallmarks that result in physiologic decline of most body systems. This may culminate in frailty, a state of decreased reserve. Because frailty is a state of multisystem dysregulation, multimodal interventions may be necessary to mitigate and prevent progression rather than interventions targeting a single system. Movement-based mind-body therapies, such as tai chi and yoga, are promising multimodal strategies for frailty prevention and treatment given their inherent multicomponent nature. In this review, we summarize the links between hallmarks of aging and frailty and how tai chi and yoga may impact these hallmarks. We review trial evidence for the impact of tai chi and yoga on frailty in older populations and discuss opportunities for future research.

Protective roles of meditation practice and self-esteem on cognitive functions over time: findings from the Midlife in the United States study

BACKGROUND

Cognitive function is an important component of healthy ageing. However, it is unclear whether relaxation/meditation practices provide cognitive benefits, particularly in midlife and early late life. Meditative practices are associated with higher self-esteem, and self-esteem serves as a general protective factor for many health outcomes. The current study examines associations between meditation practice, self-esteem, and change over 10 years in midlife cognitive performance.

METHODS

Data were from waves 2 (2003-2004) and 3 (2013-2014) of the Midlife in the United States (MIDUS) study. We used structural equation modelling to examine whether persistent meditation practice at both waves or episodic practice at one wave is associated with better cognitive function over 10 years, compared to no meditation practice, while controlling for prior cognitive function and covariates (baseline socio-demographics, health, and functional status). Additionally, we assessed if self-esteem mediates the above associations.

RESULTS

We included 2168 individuals (Mage  = 65 ± 11). After controlling for covariates, the findings revealed that persistent meditation practice in both waves was associated with significantly less decline in episodic memory; however, no such effects were found for executive function. Further, although participants' higher self-esteem was significantly associated with less decline in executive function and episodic memory, it did not mediate the associations between meditation practice and cognitive functions.

CONCLUSIONS

While both persistent meditation practice and self-esteem have associations with cognitive outcomes for middle-aged and older adults in MIDUS, self-esteem as a mediator was not supported. Thus, future investigations should examine mechanisms that underlie these protective factors on cognitive performances across adulthood.

Is Use of Psychedelic Drugs a Risk or Protective Factor for Late-Life Cognitive Decline?

Objectives: Common age-related health conditions can lead to poor mental health outcomes and deteriorate cognition. Additionally, commonly prescribed medications for various mental/physical health conditions may cause adverse reactions, especially among older adults. Psychedelic therapy has shown positive impacts on cognition and has been successful in treating various mental health problems without long-lasting adversities. The current study examines the association between psychedelic drug usage and cognitive functions in middle-aged and older adults. Methods: Data were from wave 3 (2013-2014) of the Midlife in the United States (MIDUS) study. We used multiple linear regression models examining associations between psychedelic usage and cognitive functions, controlling for covariates of sociodemographic and health factors. Results: We included 2,503 individuals (Mage = 64 ± 11). After controlling for covariates, the finding revealed that psychedelic usage was independently associated with more favorable changes in executive function (β = .102, SE = 0.047, p = .031) and less depressive symptoms (β = -.090, SE = 0.021, p < .001). The same effect was not found for episodic memory (β = .039, SE = 0.066, p = .553). Discussion: Addressing the mental health implications of physical health conditions in older adults are vital for preventing neurocognitive deterioration, prolonging independence, and improving the quality of life. More longitudinal research is essential utilizing psychedelics as an alternative therapy examining late-life cognitive benefits.

Association of exercise, brain-derived neurotrophic factor, and cognition among older women: A systematic review and meta-analysis

This systematic review and meta-analysis explored the effects of structured exercise regimens on brain-derived neurotrophic factor (BDNF) levels, a proxy for cognitive function, in older women. In this study, we collated evidence from the available clinical trials that reported BDNF levels and other outcomes following structured exercise regimens. Adhering to PRISMA Statement 2020 guidelines. PubMed/MEDLINE, Scopus, CINAHL Plus, and Cochrane were systematically searched using a combination of the following keywords: brain-derived neurotrophic factor, women, exercise, older, cognition, and/or cognitive. A random-effects model was applied; the statistical analysis was conducted in RevMan 5.4 (Cochrane). The risk of bias in the included trials was assessed using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Across 12 trials, 994 older women were included that were enrolled in different exercise regimens globally. Exercise regimens were categorized as aerobic, resistance/power training, aquatic, taekwondo, and multimodal and ranging from 30 to 60 min, 1-5 times per week across 5-24 weeks. Moderate improvement (Cohen's d: 0.44, 95% CI: 0.04-0.84, p = 0.03) was found in BDNF levels across all trials. There was a small yet insignificant improvement in mini-mental state examination (MMSE) scores (Cohen's d: 0.17, 95% CI: -0.79-1.13, p = 0.73). Aerobic exercise, aquatic exercise, and multimodal regimens showed significant association with improved BDNF levels but the sample size for individual exercise regimens was small A main limitation was the inclusion of 114 (10.3%) males in the data, introducing gender bias. This study provides novel insight into the association between various exercise regimens and BDNF levels among older women.

Effects of neuromuscular and proprioceptive training on self-reported wellness and health scores and knee sensorimotor characteristics in active seniors

INTRODUCTION

Athletes regularly engage in comprehensive neuromuscular and proprioceptive training (NPT) to prevent musculoskeletal (MSK) injuries. NPT exercises such as movement technique, agility, balance, and posture as well as yoga-based stretching and slow/deep breathing have shown added benefits in psychological and other well-being. This study aimed to examine the effects of NPT on knee sensorimotor characteristics and multi-domain wellness and health scores in active seniors.

METHODS

Twenty seniors participated in the NPT intervention (15-20min session twice a week for 10 weeks) while the control group did not receive any intervention. All participants completed surveys (general health, frailty, anxiety, stress, mindfulness, optimism, and sleep quality) and laboratory testing before and after intervention. Laboratory testing included frailty tests (grip strength, 4-m walk speed, and calcaneal ultrasound-based bone density) and knee sensorimotor characteristics (peak force, visual-motor reaction time, and force steadiness).

RESULTS

There was significant increase in general mental health (Short Form 36 Mental Health; p = 0.005) and decrease in stress (Perceived Stress Scale; p = 0.010) and sleep disturbances (Pittsburgh Sleep Quality Index; p = 0.019) post-intervention while no significant changes were observed in the control group (p = 0.310-0.654). Peak knee forces in all directions and some visual-motor reaction time and force steadiness were significantly improved post-intervention only in the experimental group (p = 0.001-0.038).

CONCLUSION

A simple, yet, comprehensive NPT has potential to improve MSK health as well as various domains of well-being among active seniors.

Impact of Yoga as an Add-On Intervention on Neurocognitive Functions Among Adult Athletes: A Pilot Study

BACKGROUND

Athletes are vulnerable to musculoskeletal injuries and psychiatric conditions. Previous studies have reported the benefits of yoga on cognitive functions among healthy children, adults, and the elderly. This pilot study aimed to test the neurocognitive functions among athletes with/without yoga intervention.

METHODS

A non-randomized, two-armed parallel-group, single-blind comparative trial was used. The participants were grouped into (i) yoga with sports activity (YSA, n = 15) and (ii) sports activity alone (SA, n = 14). The subjects were assessed at the baseline and after a one-month intervention using digit span forward (DSF), digit span backward (DSB), Trail Making Test (TMT) A & B, and Rey Auditory Verbal Learning Test (RAVLT). A comprehensive one-hour yoga training three days a week for two months constitutes selected asanas (postures), pranayama (breathing techniques), relaxation techniques, and meditation techniques. The control group constitutes the routine sports activity for the same period.

RESULTS

A paired sample t-test showed a significant improvement in cognitive performance on TMT A & B duration and RAVLT total score in the YSA group compared with the SA group. However, a significant trend was observed for DSF, DSB, and RAVLT immediate recall. Independent sample t-test (pre-post change scores) showed no significant group difference in cognitive performance, except there was a significant trend observed related to DSF (p = 0.053) and RAVLT distraction (p = 0.09), where the yoga group showed better performance in cognitive functions.

CONCLUSION

The results suggest that yoga may be integrated with sports to enhance neurocognitive functions.

Mind body exercise improves cognitive function more than aerobic- and resistance exercise in healthy adults aged 55 years and older - an umbrella review

Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults ≥ 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acute exercise. Variation across studies due to heterogeneity was considered very high.Conclusions Mind-body exercise has moderate positive effects on the cognitive function of people aged 55 or older. To promote healthy aging, mind-body exercise should be used over a prolonged period to complement other types of exercise. Results of this review should be used to inform the development of guidelines to promote healthy aging.Trial registration PROSPERO (CDR 42022312955).

An RCT-reticulated meta-analysis of six MBE therapies affecting college students' negative psychology

The positive impact of mind-body movement therapy on mental health has been confirmed, but the current effect of various mind-body movement-specific therapies on improving the negative psychology of college students is controversial. This study compared the effects of six mind-body exercise (MBE) therapies on improving negative psychological symptoms in college students. The study found that Tai Chi (standardized mean difference [SMD] = -0.87, 95% confidence interval [CI] (-1.59, -0.15), p < 0.05), yoga (SMD = -0.95, 95% CI (-1.74, -0.15), p < 0.05), Yi Jin Jing (SMD = -1.15, 95% CI (-2.36, -0.05), p=<0.05), Five Animal Play (SMD = -1.1, 95% CI (-2.09, -0.02), p < 0.05), and Qigong Meditation (SMD = -1.31, 95% CI (-2.2, -0.4), p < 0.05) improved depressive symptoms in college students (p < 0.05). Tai Chi (SMD = -7.18, 95% CI (-13.18, -1.17), p = 0.019), yoga (SMD = -6.8, 95% CI (-11.79, -1.81), p = 0.008), and Yi Jin Jing (SMD = -9.21, 95% CI (-17.55, -0.87), p = 0.03) improved college students' anxiety symptoms. It shows that the six MBE therapies are effective in improving anxiety and depression in college students.

Impact of Diet and Exercise Interventions on Cognition and Brain Health in Older Adults: A Narrative Review

The ability to preserve cognitive function and protect brain structure from the effects of the aging process and neurodegenerative disease is the goal of non-pharmacologic, lifestyle interventions focused on brain health. This review examines, in turn, current diet and exercise intervention trends and the collective progress made toward understanding their impact on cognition and brain health. The diets covered in this review include the Mediterranean diet (MeDi), Dietary Approaches to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), ketogenic diet, intermittent fasting, and weight loss management. The exercise approaches covered in this review include endurance, resistance, combined exercise programs, yoga, tai chi, and high-intensity interval training. Although valuable evidence is building concerning how diet and exercise influence cognitive performance and brain structure, many of the open questions in the field are concerned with why we see these effects. Therefore, more strategically designed intervention studies are needed to reveal the likely multiple mechanisms of action in humans.

Effect of Yoga on Frailty in Older Adults : A Systematic Review

BACKGROUND

Yoga, a multicomponent mind-body practice, improves several domains of physical and psychological health and may affect frailty in older adults.

PURPOSE

To evaluate the available trial evidence on the effect of yoga-based interventions on frailty in older adults.

DATA SOURCES

MEDLINE, EMBASE, and Cochrane Central from their inception to 12 December 2022.

STUDY SELECTION

Randomized controlled trials evaluating the effect of yoga-based interventions, including at least 1 session of physical postures, on a validated frailty scale or single-item markers of frailty in adults aged 65 years or older.

DATA EXTRACTION

Two authors independently screened articles and extracted data; 1 author assessed risk of bias with review from a second author. Disagreements were resolved through consensus and as-needed input from a third author.

DATA SYNTHESIS

Thirty-three studies (n = 2384 participants) were identified in varied populations, including community dwellers, nursing home residents, and those with chronic disease. Yoga styles were primarily based on Hatha yoga and most often included Iyengar or chair-based methods. Single-item frailty markers included measures of gait speed, handgrip strength, balance, lower-extremity strength and endurance, and multicomponent physical performance measures; no studies included a validated definition of frailty. When compared with education or inactive control, there was moderate-certainty evidence that yoga improved gait speed and lower-extremity strength and endurance, low-certainty evidence for balance and multicomponent physical function measures, and very low-certainty evidence for handgrip strength.

LIMITATION

Heterogeneity in study design and yoga style, small sample sizes, and reporting deficiencies leading to concerns for selection bias.

CONCLUSION

Yoga may affect frailty markers that are associated with clinically meaningful outcomes in older adult populations but may not offer benefit over active interventions (for example, exercise).

PRIMARY FUNDING SOURCE

None. (PROSPERO: CRD42020130303).

Impact of Yoga Versus Memory Enhancement Training on Hippocampal Connectivity in Older Women at Risk for Alzheimer's Disease

BACKGROUND

Yoga may be an ideal early intervention for those with modifiable risk factors for Alzheimer's disease (AD) development.

OBJECTIVE

To examine the effects of Kundalini yoga (KY) training versus memory enhancement training (MET) on the resting-state connectivity of hippocampal subregions in women with subjective memory decline and cardiovascular risk factors for AD.

METHODS

Participants comprised women with subjective memory decline and cardiovascular risk factors who participated in a parent randomized controlled trial (NCT03503669) of 12-weeks of KY versus MET and completed pre- and post-intervention resting-state magnetic resonance imaging scans (yoga: n = 11, age = 61.45±6.58 years; MET: n = 11, age = 64.55±6.41 years). Group differences in parcellated (Cole-anticevic atlas) hippocampal connectivity changes (post- minus pre-intervention) were evaluated by partial least squares analysis, controlling for age. Correlations between hippocampal connectivity and perceived stress and frequency of forgetting (assessed by questionnaires) were also evaluated.

RESULTS

A left anterior hippocampal subregion assigned to the default mode network (DMN) in the Cole-anticevic atlas showed greater increases in connectivity with largely ventral visual stream regions with KY than with MET (p < 0.001), which showed associations with lower stress (p < 0.05). Several posterior hippocampal subregions assigned to sensory-based networks in the Cole-anticevic atlas showed greater increases in connectivity with regions largely in the DMN and frontoparietal network with MET than with KY (p < 0.001), which showed associations with lower frequency of forgetting (p < 0.05).

CONCLUSION

KY training may better target stress-related hippocampal connectivity, whereas MET may better target hippocampal sensory-integration supporting better memory reliability, in women with subjective memory decline and cardiovascular risk factors.

Promoting Resilience and Flourishing Among Older Adult Residents in Community Living: A Feasibility Study

BACKGROUND AND OBJECTIVES

The Stress Management and Relaxation Training-Relaxation Response Resiliency Program (SMART-3RP) is a mind-body group intervention that integrates relaxation training with cognitive behavioral and positive psychology techniques. This study assessed SMART-3RP feasibility, acceptability, and preliminary efficacy for enhancing resilience and flourishing among older adults in continuing care retirement communities (CCRCs).

RESEARCH DESIGN AND METHODS

We conducted a prospective single-arm study of SMART-3RP groups delivered by clinicians at 4 CCRCs (n = 80). Eligible residents lived in community apartments. Participants completed pre- and postintervention surveys. We evaluated attendance (hypothesis: ≥60% attend ≥6 of 9 sessions), enrollment, and retention. Mixed methods were used to explore acceptability. Paired samples t-tests were conducted to explore changes in resilience, flourishing, and key intervention targets.

RESULTS

From March to June 2021, we screened 89 residents with 87 (98%) consenting to participate and 80 (90%) enrolling in the study. Among 80 participants (85% female; 98% non-Hispanic White; M age = 80 years [SD = 6]), 88% attended ≥6 sessions, and 89% completed the postintervention survey. Participants found meaning in participation and practiced skills in the context of challenges such as caregiving burden or bereavement. Survey results, showing increases in resilience, flourishing, and several intervention targets, aligned with participants' perceived intervention value.

DISCUSSION AND IMPLICATIONS

SMART-3RP was feasible and acceptable for CCRC residents; participants perceived value in practicing mind-body strategies in a group-based setting. Preliminary evidence suggested a pattern of improvements in resilience, flourishing, and intervention targets. Findings provide insights for mind-body interventions and recommendations for adaptations to late-in-life concerns and community settings.

CLINICAL TRIALS REGISTRATION NUMBER

NCT04720014.

The Impact of a Yoga-Based Mindfulness Intervention versus Psycho-Educational Session for Older Adults with Mild Cognitive Impairment: The Protocol of a Randomized Controlled Trial

BACKGROUND

There is a global agreement in the medical community that a significant proportion of dementia cases could be prevented or postponed. One of the factors behind this agreement comes from scientific evidence showing that mind-body interventions such as mindfulness and yoga for the elderly have been related to a range of positive outcomes, including improved cognition performance in seniors with mild cognitive impairment (MCI).

OBJECTIVE

This study aims to evaluate the effectiveness of a yoga-based mindfulness intervention (YBM) versus psychoeducational sessions for older adults with MCI attending Hospital Clinic Universidad de Chile in Santiago.

METHOD

Two-arm, individually randomized controlled trial (RCT) will be carried out at Clinical Hospital Universidad de Chile in Santiago. Older people over 60 years with any type of MCI using a score < 21 in the Montreal Cognitive Assessment (MoCA) test and a score of 0.05 in the Clinical Dementia Rating (CDR) Scale; and with preserved activities of daily living will be randomly assigned with an allocation ratio of 1:1 in either the yoga-based mindfulness intervention or the active control group based on the psycho-educational program. People who have performed yoga and/or mindfulness in the last 6 months or/and people with a psychiatric clinical diagnosis will be excluded from the study. Montreal Cognitive Assessment, the Lawton Instrumental Activities of Daily Living Scale (IADL), the Barthel Index (BI), the Pemberton happiness index, the Geriatric Anxiety Inventory (GAI) as well as the Geriatric Depression Scale (GDS-5) will be administered by blinded outcomes assessors before random assignment (Pre-test), the week following the last session of the intervention (post-test), and then after 3- and 6-months follow-up.

RESULTS

The YBM intervention protocol based on a video recording has been adapted and designed. This is the first RCT to examine the effects of a yoga-based mindfulness intervention in improving cognitive and physical functions and mental health outcomes for Chilean elderly diagnosed with MCI. It is expected to be implemented as an acceptable and effective non-pharmacological option for older people with MCI.

CONCLUSION

Providing evidence-based programs such as preventive therapy for Alzheimer's disease has relevant implications for public mental health services in Chile.

Effects of remote ischemic conditioning on cognitive performance: A systematic review

The aging process leads to subtle decline in cognitive function, and in some overt dementia. Like physical activity Remote Ischemic Conditioning (RIC) may ameliorate these changes on cognitive impairment in humans. The purpose of this study was to compared the effects of single, repeated short-term and long-term treatment RIC, and analyze its effect registered as immediate vs. long-term on cognitive performance in humans. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered with PROSPERO, number (CRD42021285668). A systematic review was conducted to identify relevant studies through six healthcare science databases (Cochrane, PubMed, EMBASE, EBSCO, Scopus, and Web of Science) up to December 2021. Eligibility criteria included (1) a study sample of participants aged ≥18 years, (2) post-intervention changes on cognitive performance in humans, and (3) this systematic review included only randomized controlled trials of RIC in humans. The quality of the included studies was assessed by GRADEpro tool. A total of 118 articles were initially identified, 35 of which met the inclusion criteria. Based on title/abstract, age and RIC protocol, 14 articles were included in this review: 5 studies investigated the immediate and long-term effect of a single RIC (n = 370 patients), 4 studies examined intermittent short-term RIC (n = 174 patients) and 5 studies evaluated repeated long-term RIC (n = 228 patients). A single pre-operative RIC treatment had an immediate effect that disappeared at one week. Short-term RIC showed either a positive or no effects on cognitive function. The majority of studies examining long-term RIC treatment showed improvements in cognitive performance, particularly in very old adults and older patients with cognitive impairments. Single RIC treatment did not show any persisting effect on cognition. However, repeated short term RIC showed some improvement and long-term RIC may improve cognitive performance after stroke or enhance neuropsychological tests in patients diagnosed with vascular dementia. The mixed results might be explained by different RIC treatment protocols and populations investigated.

Complementary and Integrative Medicine for Neurocognitive Disorders and Caregiver Health

PURPOSE OF REVIEW

Integrative medicine is the practice of combining conventional medical treatments with "alternative" or "complementary" therapies. Integrative psychiatry is a holistic, person-centered approach to neuropsychiatric disorders that emphasizes a person's physical, emotional, interpersonal, behavioral, nutritional, environmental, and spiritual dimensions to achieve well-being. Older adults are more prone to physical injury, interpersonal loss, chronic illnesses, and physical and cognitive decline that can manifest as anxiety, depression, with functional decline and inability to care for self. Additionally, stress of caring for older adults with dementia can adversely affect caregivers' health. Although integrative approaches are perceived as safer and less stigmatizing, it is important to understand the risks and benefits of such therapies for older adults with neurocognitive disorders and their caregivers.

RECENT FINDINGS

Here, we summarize the results of the recent clinical trials and meta-analyses that provide evidence for integrative approaches to treating older adults with cognitive disorders and their caregivers which include the use of diet and supplements, and mind-body therapies. Dietary and mind-body therapies have become increasingly popular and show the strongest evidence of effectiveness for cognitive disorders and caregiver stress. Vitamins and supplements are the most popular integrative intervention, but there is mixed evidence supporting their use and the concern for herb (supplement)-drug interactions. While there is increasing popularity of integrative treatments, information to guide clinicians providing care for older adults remains limited, with variable scientific rigor of the available RCTs for a large number of commonly used integrative interventions particularly for cognitive disorders and caregiver stress and well-being.

Exercise Training for Mild Cognitive Impairment Adults Older Than 60: A Systematic Review and Meta-Analysis

Background:

The prevalence of mild cognitive impairment (MCI) continues to increase due to population aging. Exercise has been a supporting health strategy that may elicit beneficial effects on cognitive function and prevent dementia.

Objective:

This study aimed to examine the effects of aerobic, resistance, and multimodal exercise training on cognition in adults aged > 60 years with MCI.

Methods:

We searched the Cochrane Library, PubMed, and Embase databases and ClinicalTrials.gov (https://clinicaltrials.gov) up to November 2021, with no language restrictions. We included all published randomized controlled trials (RCTs) comparing the effect of exercise programs on cognitive function with any other active intervention or no intervention in participants with MCI aged > 60 years.

Results:

Twelve RCTs were included in this review. Meta-analysis results revealed significant improvements in resistance training on measures of executive function (p < 0.05) and attention (p < 0.05); no significant differences were observed between aerobic exercise and controls on any of the cognitive comparisons.

Conclusion:

Exercise training had a small beneficial effect on executive function and attention in older adults with MCI. Larger studies are required to examine the effects of exercise and the possible moderators.

Yoga Prevents Gray Matter Atrophy in Women at Risk for Alzheimer's Disease: A Randomized Controlled Trial

BACKGROUND

Female sex, subjective cognitive decline (SCD), and cardiovascular risk factors (CVRFs) are known risk factors for developing Alzheimer's disease (AD). We previously demonstrated that yoga improved depression, resilience, memory and executive functions, increased hippocampal choline concentrations, and modulated brain connectivity in older adults with mild cognitive impairment.

OBJECTIVE

In this study (NCT03503669), we investigated brain gray matter volume (GMV) changes in older women with SCD and CVRFs following three months of yoga compared to memory enhancement training (MET).

METHODS

Eleven women (mean age = 61.45, SD = 6.58) with CVRF and SCD completed twelve weeks of Kundalini Yoga and Kirtan Kriya (KY + KK) while eleven women (mean age = 64.55, SD = 6.41) underwent MET. Anxiety, resilience, stress, and depression were assessed at baseline and 12 weeks, as were T1-weighted MRI scans (Siemens 3T Prisma scanner). We used Freesurfer 6.0 and tested group differences in GMV change, applying Monte-Carlo simulations with alpha = 0.05. Region-of-interest analysis was performed for hippocampus and amygdala.

RESULTS

Compared to KY + KK, MET showed reductions in GMV in left prefrontal, pre- and post-central, supramarginal, superior temporal and pericalcarine cortices, right paracentral, postcentral, superior and inferior parietal cortices, the banks of the superior temporal sulcus, and the pars opercularis. Right hippocampal volume increased after yoga but did not survive corrections.

CONCLUSION

Yoga training may offer neuroprotective effects compared to MET in preventing neurodegenerative changes and cognitive decline, even over short time intervals. Future analyses will address changes in functional connectivity in both groups.

Meta-Analysis of the Effect of Yoga Practice on Physical Fitness in the Elderly

The purpose of this study was to meta-analyze the effects of yoga intervention on physical fitness in the elderly. The following databases were systematically searched in 25 March 2021: Cochrane, PubMed and Embase. A total of 656 papers was identified through key word combinations, finally, 12 studies were included in the meta-analysis. The main conclusions are as follows. First, yoga practice showed moderately positive effects on muscle strength, balance, mobility, and lower body flexibility, but had no significant effect on cardiorespiratory endurance and upper body flexibility. Second, sub-group analysis showed that subjects in their 60s and 70s and yoga practice for 9–12 weeks had a large positive effect on physical fitness. Yoga is a multimodal activity that improves muscle strength, balance, and flexibility in the elderly, and physical activity policies should continue to promote yoga as an activity that enhances physical and mental wellbeing in this population.

Computerized Cognitive Training (CCT) versus Yoga Impact on 12 Month Post Intervention Cognitive Outcome in Individuals with Mild Cognitive Impairment

There is currently limited and mixed evidence for the cognitive benefits of Computerized Cognitive Training (CCT) and yoga in persons with Mild Cognitive Impairment (pwMCI). The objective of this study was to investigate the benefit of computerized cognitive training (CCT) vs. physical (yoga) intervention on cognitive abilities. Participants in this study were part of the larger Mayo Clinic’s Healthy Action to Benefit Independence and Thinking (HABIT) program comparative effectiveness trial. The HABIT program is designed for pwMCI and their care partner and consists of five behavioral interventions: CCT, Memory Support System-Calendar (MSS-Calendar), wellness education, support groups, and yoga. The subtractive study design randomly withheld one of the interventions for a total of five study arms. Longitudinal mixed-effects regression models were used to investigate the hypothesis that CCT and yoga has a greater positive impact on psychomotor and basic attention abilities at 12 months post-intervention as compared to the other HABIT interventions. Findings showed CCT had a positive impact compared to yoga on the Cogstate psychomotor/attention composite at 12 months post-intervention (ES = 0.54; unadjusted p value = 0.007, adjusted p value = 0.021). The impact of yoga or combining CCT with yoga did not show statistically significant improvement. Continued CCT practice at home showed further benefit on psychomotor/attention at 12 months post-intervention. There was no significant benefit of CCT or yoga on Cogstate learning/working memory composite.