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Marmamula S, Kumbham TR, Modepalli SB, Barrenkala NR, Keeffe JE, Friedman DS. Cross-sectional study of prevalence and correlates of fear of falling in the older people in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES). BMJ Open 2024; 14:e080973. [PMID: 38806424 PMCID: PMC11138276 DOI: 10.1136/bmjopen-2023-080973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 04/25/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVE To report the prevalence and risk factors for the fear of falling (FOF) among older individuals living in residential care facilities in India. DESIGN Cross-sectional study. SETTING Homes for the aged centres in Hyderabad, India. PARTICIPANTS The study included individuals aged ≥60 years from homes for the aged centres. The participants underwent a comprehensive eye examination in make-shift clinics setup in homes. Trained investigators collected the personal and demographic information of the participants and administered the Patient Health Questionnaire-9 and Hearing Handicap Inventory for Elderly questionnaire in the vernacular language. FOF was assessed using the Short Falls Efficacy Scale. The presence of hearing and visual impairment in the same individual was considered dual sensory impairment (DSI). A multiple logistic regression analysis was done to assess the factors associated with FOF. PRIMARY OUTCOME MEASURE FOF. RESULTS In total, 867 participants were included from 41 homes for the aged centres in the analyses. The mean (±SD) age of the participants was 74.2 (±8.3) years (range 60-96 years). The prevalence of FOF was 56.1% (95% CI 52.7% to 59.4%; n=486). The multivariate analysis showed that those with DSI had eleven times higher odds of reporting FOF than those with no impairment (OR 11.14; 95% CI 3.15 to 41.4.) Similarly, those with moderate depression had seven times higher odds (OR 6.85; 95% CI 3.70 to 12.70), and those with severe depression had eight times higher odds (OR 8.13; 95% CI 3.50 to 18.90) of reporting FOF. A history of falls in the last year was also associated with increased odds for FOF (OR 1.52; 95% CI 1.03 to 2.26). CONCLUSION FOF is common among older individuals in residential care in India. Depression, falling in the previous year and DSI were strongly associated with FOF. A cross-disciplinary approach may be required to address FOF among the older people in residential care in India.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- Wellcome Trust / Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Jill Elizabeth Keeffe
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - David S Friedman
- Harvard Medical School Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
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Frampton K, Oppedijk L, Hadley R, Annett LE. Reduced Anxiety and Depression and Improved Mood in Older Adults Living in Care Homes After Participating in Chair Yoga. J Appl Gerontol 2024:7334648241241298. [PMID: 38522958 DOI: 10.1177/07334648241241298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
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.
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Affiliation(s)
- Keeley Frampton
- Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, UK
| | | | - Rebecca Hadley
- Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, UK
| | - Lucy E Annett
- Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, UK
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Küçük Öztürk G, Yüceler Kaçmaz H, Öztürk Rİ. Narrative Experiences of Individuals with Lower Limb Amputation: A Qualitative Study. INT J LOW EXTR WOUND 2024; 23:92-98. [PMID: 35311367 DOI: 10.1177/15347346221087497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Aim: The present study aimed to determine the narrative experiences of individuals undergoing lower limb amputation. Method: This study was a qualitative study conducted using the phenomenological pattern. Using purposive sampling, 13 individuals with lower limb amputation were selected and interviewed. Data were collected using semi-structured interviews and analyzed using the content analysis method. Results: The mean age of the 13 individuals was 51.17 ± 8.7 years. Five of the individuals were female and eight of them were male. A main theme and four sub-themes were identified. This main theme together with sub-themes were Dead End (Process of Loss, Negative Feelings, Change, Adapting to New Life). The individuals expressed mostly negative feelings and thoughts while also emphasizing the rehabilitation process (positive sides). Conclusions: Individuals with lower limb amputations stated there were positive factors affecting the rehabilitation process while emphasizing negative thoughts and feelings during the amputation process. These results can be used in planning for training, counseling and therapeutic interviews to protect the psychosocial health of individuals with lower limb amputation.
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Affiliation(s)
- Gülhan Küçük Öztürk
- Department of Psychiatric Nursing, Nevşehir Hacı Bektaş Veli University Semra and Vefa Küçük Faculty of Health Sciences, Nevşehir, Turkey
| | - Hatice Yüceler Kaçmaz
- Department of Surgical Nursing, Erciyes University Health Sciences Faculty, Kayseri Turkey
| | - Ramazan İlter Öztürk
- Department of Orthopedics and Traumatology, Republic of Turkey Ministry of Health, Nevşehir State Hospital, Nevşehir, Turkey
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Loewenthal JV, Farkas EJ, McGough K, Tomita B, Wayne PM, Orkaby AR. The impact of yoga on aging physiology: A review. J Nutr Health Aging 2024; 28:100005. [PMID: 38388108 DOI: 10.1016/j.jnha.2023.100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 02/24/2024]
Abstract
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.
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Affiliation(s)
- Julia V Loewenthal
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Eva J Farkas
- Tufts University School of Medicine, Boston, MA, USA
| | - Katherine McGough
- University of Missouri-Columbia School of Medicine, Columbia, MO, USA
| | | | - Peter M Wayne
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA; Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ariela R Orkaby
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA
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Loewenthal J, Berning MJ, Wayne PM, Eckstrom E, Orkaby AR. Holistic frailty prevention: The promise of movement-based mind-body therapies. Aging Cell 2024; 23:e13986. [PMID: 37698149 PMCID: PMC10776124 DOI: 10.1111/acel.13986] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023] Open
Abstract
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.
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Affiliation(s)
- Julia Loewenthal
- Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Peter M. Wayne
- Division of Preventive MedicineBrigham and Women's HospitalBostonMassachusettsUSA
- Osher Center for Integrative Medicine, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Elizabeth Eckstrom
- Division of General Internal Medicine & GeriatricsOregon Health & Science UniversityPortlandOregonUSA
| | - Ariela R. Orkaby
- Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- New England Geriatric Research, Education, and Clinical Center (GRECC)VA Boston Healthcare SystemBostonMassachusettsUSA
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Sharma H, Swetanshu, Singh P. Role of Yoga in Cardiovascular Diseases. Curr Probl Cardiol 2024; 49:102032. [PMID: 37582455 DOI: 10.1016/j.cpcardiol.2023.102032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023]
Abstract
Cardiovascular diseases are a collection of conditions that affect the blood vessels and the heart. These conditions include cardiac rehabilitation, hypertension, cardiac failure, rheumatic heart disease, peripheral artery disease, and coronary heart disease. Poor nutrition, alcohol, lack of exercise, smoking, etc are the main behavioral risk factors for heart disease. This study delivers a methodical review of yoga's role in the management and inhibition of cardiovascular diseases and their associated risk factors. This review suggests that proper maintenance of fitness and stress employing yoga effectively lowers cardiovascular disease. In this review, various asanas, and pranayama like Marjaryasana, Kapalabhati, Halasana, etc have been discussed. Also, their role in the prevention of coronary heart disease (CHD). In addition to this different metabolic syndrome associated with cardiovascular diseases and the relation of yoga with hypertension has been discussed. The review has documented satisfactory proof and concludes that yogic exercise enhances cardiovascular health and reduces associated risk factors.
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Affiliation(s)
- Harshita Sharma
- School of Biological and Life Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Swetanshu
- School of Biological and Life Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Pratichi Singh
- School of Biological and Life Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India.
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Majumdar V, Manjunath NK, Snigdha A, Chakraborty P, Majumdar R. Study protocol on effectiveness of yoga practice on composite biomarker age predictors (yBioAge) in an elderly Indian cohort- two-armed open label randomized controlled trial. BMC Geriatr 2023; 23:864. [PMID: 38102561 PMCID: PMC10724948 DOI: 10.1186/s12877-023-04517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION The recent development of robust indices to quantify biological aging, along with the dynamic epidemiological transitions of population aging generate the unmet need to examine the extent up to which potential interventions can delay, halt or temporarily modulate aging trajectories. METHODS AND ANALYSIS The study is a two-armed, open label randomised controlled trial. We aim to recruit 166 subjects, aged 60-75 years from the residential communities and old age clubs in Bangalore city, India, who will undergo randomisation into intervention or control arms (1:1). Intervention will include yoga sessions tailored for the older adults, 1 h per day for 5 days a week, spread for 12 months. Data would be collected at the baseline, 26th week and 52nd week. The primary outcome of the study is estimation in biological age with yoga practice. The secondary outcomes will include cardinal mechanistic indicators of aging- telomere length, interleukin-6 (IL-6), tumor necrosis factor receptor II (TNF-RII), high sensitivity c-reactive protein (hsCRP)], insulin signaling [insulin and IGF1], renal function [cystatin], senescence [growth differentiating factor 15 (GDF-15)] and cardiovascular function [N-terminal B-type natriuretic peptides (NT-proBNP)]. Analyses will be by intention-to-treat model. ETHICS & DISSEMINATION The study is approved by the Institutional Ethics Committee of Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore (ID:RES/IEC-SVYASA/242/2022). Written informed consent will be obtained from each participant prior to inclusion. TRIAL REGISTRATION NUMBER CTRI/2022/07/044442.
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Affiliation(s)
- Vijaya Majumdar
- Division of Life Science, Molecular Bioscience Lab, Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, Karnataka, 560105, India.
| | - N K Manjunath
- Division of Life Science, Molecular Bioscience Lab, Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, Karnataka, 560105, India
| | - Atmakur Snigdha
- Division of Life Science, Molecular Bioscience Lab, Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, Karnataka, 560105, India
| | - Prosenjeet Chakraborty
- Division of Life Science, Molecular Bioscience Lab, Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, Karnataka, 560105, India
| | - Robin Majumdar
- Indian Institute of Information Technology, Bangalore, Karnataka, 560100, India
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Park J, Wiese LAK, Holt J. Online Chair Yoga and Digital Learning for Rural Underserved Older Adults at Risk for Alzheimer's Disease and Related Dementias. Clin Gerontol 2023:1-17. [PMID: 37941382 DOI: 10.1080/07317115.2023.2277333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVES We evaluated the feasibility and preliminary efficacy of a home-based online chair yoga (OCY) program for racially and ethnically diverse rural community-dwelling older adults. METHODS We randomly assigned participants to OCY or a computer brain game (CBG). After a computer literacy training led by high school students, participants engaged in remotely supervised OCY or CBG in twice-weekly 45-minute sessions for 12 weeks. Outcome data (pain interference, cognitive function, mobility, computer skills) were collected at baseline, post-intervention, and 3-month follow-up. RESULTS A total of 32 eligible residents with mean age of 71 years participated in this intervention study. The interventions were feasible (100% recruitment rate, 96.8% retention rate, 100% safety rate). There were significant improvements in pain interference, cognitive function, mobility, and computer skills from baseline to follow-up among participants in both OCY and CBG but no significant differences in outcomes between groups. CONCLUSIONS Preliminary results indicated that the CBG was as effective as online OCY in clinical outcomes in these participants. However, this should be confirmed in future studies. CLINICAL IMPLICATIONS This telehealth-based intervention is feasible for older adults in rural and digitally underserved communities and could provide a strategy for delivering health-promoting interventions for home-bound older adults at risk for Alzheimer's disease and related dementias (ADRD) and connect caregivers to online resources.
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Affiliation(s)
- Juyoung Park
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
| | - Lisa Ann Kirk Wiese
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
| | - Janet Holt
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
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Chobe MP, Nanjundaiah RM, Chobe S, Raghuram N. Effect of yoga on adipokine levels among overweight and obese people: A systematic review. J Ayurveda Integr Med 2023; 14:100813. [PMID: 38041935 PMCID: PMC10711476 DOI: 10.1016/j.jaim.2023.100813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/09/2022] [Accepted: 10/18/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Adipokines have an important role in the pathophysiology of overweight and obesity and associated inflammatory diseases. OBJECTIVE The present review aims to evaluate the role of Yoga on adipokines among people with overweight and obesity. METHODS Authors performed a systematic search for relevant research studies as per the PRISMA guidelines in Google Scholar, Medline/Pubmed, Scopus, Web of Science, PsychInfo electronic databases. Two independent authors conducted the selection of articles, data extraction, assessment of the risk of bias for individual studies. Any disagreements were resolved by discussion with the third author. RESULTS Eight randomized trials and four uncontrolled trials involving a total of 1054 participants were included. Yoga with varying frequencies was administered for different durations. The studied adipokines among overweight and obese were leptin, adiponectin, interleukin-6 (IL-6), Tumor necrosis factor-alpha (TNF-α), chemerin, visfatin, plasminogen activator inhibitor-1 (PAI-1), and transforming growth factor-beta (TGF-β). The methodological quality of the included studies was low to moderate on the Cochrane risk of bias tool and Newcastle-Ottawa Quality Assessment Scale. The higher the frequency and duration of Yoga practice, the more significant changes in the adipokine levels were seen. CONCLUSION The present review indicates that Yoga practices positively impacts adipokines among people with overweight and obesity. However, the present study precludes the generalizability of results due to the methodological heterogeneity, the type of Yoga intervention, and settings.
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Affiliation(s)
- Meenakshi P Chobe
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bengaluru, India; Department of Yoga, Central University of Rajasthan, Ajmer, India
| | - Ramesh Mavathur Nanjundaiah
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bengaluru, India
| | - Shivaji Chobe
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bengaluru, India; Department of Yoga, Central University of Rajasthan, Ajmer, India.
| | - Nagaratna Raghuram
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA University), Bengaluru, India
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Phansikar M, Gothe N, Hernandez R, Lara-Cinisomo S, Mullen SP. Feasibility and impact of a remote moderate-intensity yoga intervention on stress and executive functioning in working adults: a randomized controlled trial. J Behav Med 2023; 46:720-731. [PMID: 36754937 PMCID: PMC9908305 DOI: 10.1007/s10865-022-00385-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/09/2022] [Indexed: 02/10/2023]
Abstract
The feasibility of a moderate-intensity yoga intervention, delivered remotely via supervised and unsupervised sessions, and its psychosocial and cognitive effects have not been thoroughly investigated. This randomized controlled trial assessed feasibility and preliminary efficacy of an 8-week moderate-intensity yoga intervention (3×/week, 50 min) delivered remotely (vs. a waitlist control arm), on stress and cognitive functioning. Participants (n = 86) were low active, full-time working adults (81.40% female; Mage = 41 years) with symptoms of stress. Feasibility was assessed via adherence, enjoyment, and safety; stress and anxiety via self-report questionnaires; and executive functioning via neuropsychological tests. Overall attendance was 75.1%, 100% of participants enjoyed the intervention, and only one adverse event was reported. At follow-up, the yoga group had significantly lower stress and anxiety, and higher accuracy on working memory tasks. Remote moderate intensity yoga practice proved safe, enjoyable, and may reduce stress and improve cognitive functioning. This study was pre-registered on ClinicalTrials.gov (NCT04740229).
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Affiliation(s)
- Madhura Phansikar
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, USA
| | - Neha Gothe
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, USA
| | - Rosalba Hernandez
- School of Social Work, University of Illinois Urbana-Champaign, Champaign, USA
| | - Sandraluz Lara-Cinisomo
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, USA
| | - Sean P. Mullen
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, USA
- Center for Social & Behavioral Science, University of Illinois Urbana-Champaign, Champaign, USA
- Informatics Program, University of Illinois Urbana-Champaign, Champaign, USA
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Gothe NP, Erlenbach E, Garcia V, Malani R, Voss S, Camacho PB, McAuley E, Burd N, Sutton BP, Damoiseaux JS. Yoga, aerobic and stretching exercise effects on neurocognition: Randomized controlled trial protocol. Contemp Clin Trials 2023; 131:107240. [PMID: 37244365 PMCID: PMC10527553 DOI: 10.1016/j.cct.2023.107240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/09/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
As the global population ages, the prevalence of cognitive decline and dementia is expected to rise, creating a significant health and economic burden. The purpose of this trial is to rigorously test, for the first time, the efficacy of yoga training as a physical activity intervention to mitigate age-related cognitive decline and impairment. We are conducting a 6-month randomized controlled trial (RCT) of exercise among 168 middle aged and older adults to compare the efficacy of yoga vs. aerobic exercise on cognitive function, brain structure and function, cardiorespiratory fitness, and circulating inflammatory and molecular markers. Using a single-blind, three arm RCT, 168 older adults ages 55-79 will be assigned to either: a Hatha yoga group, an aerobic exercise group or a stretching-toning active control group. Participants will engage in hour long group exercise 3x/week for 6-months. A comprehensive neurocognitive test battery, brain imaging, cardiovascular fitness test, and a blood draw will take place at baseline; end of the 6-month intervention, and at 12-month follow-up. Our primary outcomes of interest are brain regions, such as hippocampal volume and prefrontal cortex, and cognitive functions, such as episodic memory, working memory and executive functions, that are typically affected by aging and Alzheimer's disease. Not only will this RCT test whether yoga is a means to mitigate age-related cognitive decline, but it may also offer an alternative to aerobic exercise, which could be particularly appealing to older adults with compromised physical functioning. ClinicalTrials.gov Identifier: NCT04323163.
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Affiliation(s)
- Neha P Gothe
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Urbana, IL, USA; Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA.
| | - Emily Erlenbach
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Veronica Garcia
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Revati Malani
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Stephanie Voss
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Paul B Camacho
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Urbana, IL, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Urbana, IL, USA
| | - Nicholas Burd
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Bradley P Sutton
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana Champaign, Urbana, IL, USA
| | - Jessica S Damoiseaux
- Institute of Gerontology, Department of Psychology, Wayne State University, Detroit, MI, USA
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Lagera PGD, Chan SR, Yellowlees PM. Asynchronous Technologies in Mental Health Care and Education. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2023; 10:1-13. [PMID: 37360962 PMCID: PMC10157570 DOI: 10.1007/s40501-023-00286-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 06/28/2023]
Abstract
Purpose of review Patients, providers, and trainees should understand the current types of asynchronous technologies that can be used to enhance the delivery and accessibility of mental health care. Asynchronous telepsychiatry (ATP) removes the need for real time communication between the clinician and patient, which improves efficiency and enables quality specialty care. ATP can be applied as distinct consultative and supervisory models in clinician-to-clinician, clinician-to-patient, and patient-to-mobile health settings. Recent findings This review is based on research literature and the authors' clinical and medical training, using experiences with asynchronous telepsychiatry from before, during, and after the COVID-19 pandemic. Our studies demonstrate that ATP provides positive outcomes in the clinician-to-patient model with demonstrated feasibility, outcomes and patient satisfaction. One author's medical education experience in the Philippines during COVID-19 highlights the potential to utilize asynchronous technology in areas with limitations to online learning. We emphasize the need to teach media skills literacy around mental health to students, coaches, therapists, and clinicians when advocating for mental well-being. Several studies have demonstrated the feasibility of incorporating asynchronous e-tools such as self-guided multimedia and artificial intelligence for data collection at the clinician-to-clinician and patient-to-mobile health level. In addition, we offer fresh perspectives on recent trends in asynchronous telehealth in wellness, applying concepts such as "tele-exercise" and "tele-yoga." Summary Asynchronous technologies continue to be integrated into mental health care services and research. Future research must ensure that the design and the usability of this technology puts the patient and provider first.
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Affiliation(s)
- Pamela Gail D. Lagera
- Division of Hospital Medicine, Clinical Informatics, University of California, San Francisco, CA USA
| | - Steven R. Chan
- Division of Hospital Medicine, Clinical Informatics, University of California, San Francisco, CA USA
- Department of Psychiatry, University of California, San Francisco, CA USA
- Department of Psychiatry, University of California, Davis, CA USA
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13
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Loewenthal J, Innes KE, Mitzner M, Mita C, Orkaby AR. Effect of Yoga on Frailty in Older Adults : A Systematic Review. Ann Intern Med 2023; 176:524-535. [PMID: 36913687 DOI: 10.7326/m22-2553] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
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).
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Affiliation(s)
- Julia Loewenthal
- Division of Aging, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts (J.L.)
| | - Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia (K.E.I.)
| | - Margalit Mitzner
- Renaissance School of Medicine at Stony Brook University, Stony Brook, New York (M.M.)
| | - Carol Mita
- Countway Library, Harvard Medical School, Boston, Massachusetts (C.M.)
| | - Ariela R Orkaby
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, and New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts (A.R.O.)
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Welford P, Östh J, Hoy S, Rossell SL, Pascoe M, Diwan V, Hallgren M. Effects of Yoga and Aerobic Exercise on Verbal Fluency in Physically Inactive Older Adults: Randomized Controlled Trial (FitForAge). Clin Interv Aging 2023; 18:533-545. [PMID: 37021083 PMCID: PMC10069432 DOI: 10.2147/cia.s359185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/20/2022] [Indexed: 03/31/2023] Open
Abstract
Purpose To compare the effects on verbal fluency of a supported yoga-based exercise intervention to an aerobic exercise intervention and a wait-list control group. Participants and Methods Eighty-two physically-inactive but otherwise healthy adults (mean age 72.5 years, range 65-85, 77% female) were recruited into a 12-week, three-group, parallel randomized controlled trial. Participants were supported to complete ≥3 Hatha yoga classes per/week or ≥3 structured aerobic exercise sessions/week. A wait-list control group continued usual daily activities only. Verbal fluency, including total-FAS, animals, and verbs, was assessed before and after interventions. Group effects were assessed using analysis of covariance (ANCOVA). Results Twenty-seven participants were randomized to yoga, 29 to aerobic exercise and 26 to a waitlist. At 12-week follow-up, compared to baseline, there were increases in mean total-FAS in the yoga (+5.0 words, p=0.002) and aerobic exercise groups (+6.6 words, p=0.004). Mean total-FAS in the wait-list control group remained stable (-0.5 words, p=0.838). There were medium-magnitude estimated treatment effects on total-FAS for yoga versus wait-list control and aerobic exercise versus wait-list control: Hedges' g=0.51 (p=0.213) and 0.57 (p=0.098) respectively. In addition, small-to-medium magnitude estimated treatment effects were seen on animals and verbs for yoga versus wait-list control and aerobic exercise versus wait-list control: g=0.28 (p=0.155), 0.19 (p=0.766) and 0.50 (p=0.085), 0.59 (p=0.233) respectively. Conclusion Participation in yoga or aerobic exercise was associated with estimated improvements in verbal fluency compared to a non-active control group. Yoga and aerobic exercise may be promising approaches by which to promote cognitive function among older adults. Trial Registration DRKS00015093, U1111-1217-4248.
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Affiliation(s)
- Paul Welford
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Josefine Östh
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Sara Hoy
- Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Victoria, Australia
| | - Michaela Pascoe
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Vinod Diwan
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Correspondence: Mats Hallgren, Department of Global Public Health, Karolinska Institutet, Level 6, 1e Solnavägen, Solna, 11365, Sweden, Tel +46852480000, Email
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Fernandez-Gamez B, Solis-Urra P, Olvera-Rojas M, Molina-Hidalgo C, Fernández-Ortega J, Lara CP, Coca-Pulido A, Bellón D, Sclafani A, Mora-Gonzalez J, Toval A, Martín-Fuentes I, Bakker EA, Lozano RM, Navarrete S, Jiménez-Pavón D, Liu-Ambrose T, Erickson KI, Ortega FB, Esteban-Cornejo I. Resistance Exercise Program in Cognitively Normal Older Adults: CERT-Based Exercise Protocol of the AGUEDA Randomized Controlled Trial. J Nutr Health Aging 2023; 27:885-893. [PMID: 37960912 DOI: 10.1007/s12603-023-1982-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/13/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVES To provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the resistance exercise program implemented in the AGUEDA (Active Gains in brain Using Exercise During Aging) study, a randomized controlled trial investigating the effects of a 24-week supervised resistance exercise program on executive function and related brain structure and function in cognitively normal older adults. DESIGN AND PARTICIPANTS 90 cognitively normal older adults aged 65 to 80 were randomized (1:1) to a: 1) resistance exercise group; or a 2) wait-list control group. Participants in the exercise group (n = 46) performed 180 min/week of resistance exercise (3 supervised sessions per week, 60 min/session) for 24 weeks. INTERVENTION The exercise program consisted of a combination of upper and lower limb exercises using elastic bands and the participant's own body weight as the main resistance. The load and intensity were based on the resistance of the elastic bands (7 resistances), number of repetitions (individualized), motor complexity of exercises (3 levels), sets and rest (3 sets/60 sec rest), execution time (40-60 sec) and velocity (as fast as possible). SETTINGS The maximum prescribed-target intensity was 70-80% of the participants' maximum rate of perceived exertion (7-8 RPE). Heart rate, sleep quality and feeling scale were recorded during all exercise sessions. Those in the wait-list control group (n = 44) were asked to maintain their usual lifestyle. The feasibility of AGUEDA project was evaluated by retention, adherence, adverse events and cost estimation on the exercise program. RESULTS AND CONCLUSIONS This study details the exercise program of the AGUEDA trial, including well-described multi-language manuals and videos, which can be used by public health professionals, or general public who wish to implement a feasible and low-cost resistance exercise program. The AGUEDA exercise program seems to be feasible by the high retention (95.6%) and attendance rate (85.7%), very low serious adverse event (1%) and low economic cost (144.23 € /participant/24 weeks). We predict that a 24-week resistance exercise program will have positive effects on brain health in cognitively normal older adults.
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Affiliation(s)
- B Fernandez-Gamez
- Beatriz Fernandez-Gamez and Irene-Esteban-Cornejo. Department of Physical Education and Sports, Faculty of Sports Science, University of Granada; Carretera de Alfacar, 21. Granada 18071, Spain; +(34) 958 24 66 51, fax: +(34) 958 24 94 28, E-mail address: and
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Kilpatrick LA, Siddarth P, Krause-Sorio B, Milillo MM, Aguilar-Faustino Y, Ercoli L, Narr KL, Khalsa DS, Lavretsky H. Impact of Yoga Versus Memory Enhancement Training on Hippocampal Connectivity in Older Women at Risk for Alzheimer's Disease. J Alzheimers Dis 2023; 95:149-159. [PMID: 37482992 PMCID: PMC10578221 DOI: 10.3233/jad-221159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/25/2023]
Abstract
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.
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Affiliation(s)
- Lisa A. Kilpatrick
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA, USA
- Goodman-Luskin Microbiome Center, University of California, Los Angeles, CA, USA
| | - Prabha Siddarth
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Beatrix Krause-Sorio
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Michaela M. Milillo
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Yesenia Aguilar-Faustino
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Linda Ercoli
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Katherine L. Narr
- Department of Neurology, Brain Research Institute, University of California, Los Angeles, CA, USA
| | | | - Helen Lavretsky
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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Farhang M, Rojas G, Martínez P, Behrens MI, Langer ÁI, Diaz M, Miranda-Castillo C. 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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15374. [PMID: 36430097 PMCID: PMC9690706 DOI: 10.3390/ijerph192215374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
- Maryam Farhang
- Escuela de Enfermería, Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Santiago 8370040, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 8380453, Chile
- Millennium Institute for Care Research (MICARE), Santiago 8370134, Chile
- Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago 8380455, Chile
| | - Graciela Rojas
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 8380453, Chile
- Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago 8380455, Chile
| | - Pablo Martínez
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 150, Place Charles-Le Moyne, Longueuil, QC J4K A08, Canada
| | - Maria Isabel Behrens
- Centro de Investigación Clínica Avanzada (CICA), Hospital Clínico Universidad de Chile, Santiago 8380456, Chile
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago 8380456, Chile
- Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago 7800284, Chile
- Departamento de Neurología y Psiquiatría, Clínica Alemana Santiago, Universidad del Desarrollo, Santiago 7800284, Chile
| | - Álvaro I. Langer
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 8380453, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago 8380455, Chile
- Mind-Body Lab, Institute of Psychological Studies, Austral University, Valdivia 5110566, Chile
| | - Marcela Diaz
- Clínica Psiquiátrica Universitaria, Hospital Clínico, Universidad de Chile, Santiago 7800284, Chile
| | - Claudia Miranda-Castillo
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago 8380453, Chile
- Millennium Institute for Care Research (MICARE), Santiago 8370134, Chile
- Faculty of Nursing, Universidad Andres Bello, Santiago 7550000, Chile
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Malhotra V, Sampath A, Javed D, Bharshankar R, Mishra S, Singh V, Singh D, Kulkarni A, Gautam N, Rastogi R. Yoga as an Escape from Depreciating Mental Health due to COVID 19: A Qualitative study analyzing the factors associated with mental status based on the experiences of geriatric population's participation in an Online program during COVID 19 lockdown in India. Int J Yoga 2022; 15:230-239. [PMID: 36949835 PMCID: PMC10026333 DOI: 10.4103/ijoy.ijoy_121_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/06/2022] [Accepted: 11/11/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction The COVID-19 pandemic has left an array of direct physical consequences unevenly on the elderly apart from leaving a wide range of indirect consequences of mental health problems on them. This study aims to understand the effect of a Yoga-Meditation based mobile phone application intervention to reduce the duress by mental health issues via a qualitative analysis. Methods A phenomenological qualitative succession of an explanatory sequential design of a prior quantitative study followed by a Yoga-Meditation mobile phone based intervention, where 30 participants who had mild or moderate Depression, Anxiety or Stress as assessed by DASS-21 were chosen by random sampling and were asked to take part in an interview. The interview was transcribed, coded, patterns identified and themes were created to understand the perceptions. Results Three major schools of thought were identified and explored to understand the general perception of Mental health, COVID-19 and the intervention: a) Knowledge Axis patterns of COVID-19, which included their prior knowledge about the disease, its consequences and their cues to action based on those beliefs, b) Mental Health and Strategies to Positivity, involves all their actions to promote, restore or propagate a positive mental attitude from religious activities to physical activities and c) Application related thoughts, involved their perceptions of the app, the barriers to use and suggestions to improve. Conclusion This study gave deeper insight into the schools of thought which will be important in designing future interventions and yoga-meditation based programs in the future, essentially for geriatric populations as it serves as a feasible simple measure for the same.
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Affiliation(s)
- Varun Malhotra
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Ananyan Sampath
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Danish Javed
- Department of AYUSH, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Rajay Bharshankar
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Shweta Mishra
- Department of AYUSH, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Vijender Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Dibyanshu Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Deogarh, Rajasthan, India
| | - Avani Kulkarni
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Namita Gautam
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Rimjhim Rastogi
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Krause-Sorio B, Siddarth P, Kilpatrick L, Milillo MM, Aguilar-Faustino Y, Ercoli L, Narr KL, Khalsa DS, Lavretsky H. Yoga Prevents Gray Matter Atrophy in Women at Risk for Alzheimer's Disease: A Randomized Controlled Trial. J Alzheimers Dis 2022; 87:569-581. [PMID: 35275541 PMCID: PMC9198760 DOI: 10.3233/jad-215563] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 12/17/2022]
Abstract
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.
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Affiliation(s)
- Beatrix Krause-Sorio
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Prabha Siddarth
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Lisa Kilpatrick
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Michaela M. Milillo
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Yesenia Aguilar-Faustino
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Linda Ercoli
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Katherine L. Narr
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Helen Lavretsky
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California Los Angeles, Los Angeles, CA, USA
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Nguyen SA, Oughli HA, Lavretsky H. Complementary and Integrative Medicine for Neurocognitive Disorders and Caregiver Health. Curr Psychiatry Rep 2022; 24:469-480. [PMID: 35962927 PMCID: PMC9411083 DOI: 10.1007/s11920-022-01355-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Sarah A Nguyen
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; 760 Westwood Plaza, Los Angeles, CA, 90095, USA.
| | - Hanadi Ajam Oughli
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; 760 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; 760 Westwood Plaza, Los Angeles, CA, 90095, USA
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Wu C, Xu Y, Guo H, Tang C, Chen D, Zhu M. Effects of Aerobic Exercise and Mind-Body Exercise in Parkinson's Disease: A Mixed-Treatment Comparison Analysis. Front Aging Neurosci 2021; 13:739115. [PMID: 34867273 PMCID: PMC8637737 DOI: 10.3389/fnagi.2021.739115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/28/2021] [Indexed: 01/14/2023] Open
Abstract
Background/Objectives: Aerobic exercise and mind-body exercise, are vital for improving motor and non-motor functional performance of Parkinson's disease (PD). However, evidence-based recommendations on which type of exercise is most suitable for each individual are still lacking. Therefore, we conduct a network meta-analysis to assess the relative efficacy of aerobic and mind-body exercise on motor function and non-motor symptoms in Parkinson's disease and to determine which of these therapies are the most suitable. Design: A network meta-analysis and dose-response analysis. Setting and Participants: Medline, Embase (all via Ovid), and the Cochrane Central Register of Controlled Trials were comprehensively searched for related trials through April 2021. Measurements: Study quality was evaluated using the Cochrane Risk of Bias Tool. The effect sizes of continuous outcomes were calculated using mean differences (MDs) or standardized mean differences (SMDs). A network meta-analysis with a frequentist approach was conducted to estimate the efficacy and probability rankings of the therapies. The dose-response relationship was determined based on metaregression and SUCRA. Results: Fifty-two trials with 1971 patients evaluating six different therapies were identified. For the UPDRS-motor score and TUG score, yoga all ranked highest (SUCRA = 92.8%, 92.6%, respectively). The SUCRA indicated that walking may best improve the BBS score (SUCRA = 90.2%). Depression, cognitive and activities of daily living scores were significantly improved by yoga (SUCRA: 86.3, 95.1, and 79.5%, respectively). In the dose-response analysis, 60-min sessions, two times a week might be the most suitable dose of yoga for reducing the UPDRS-motor score of PD patients. Conclusion: Yoga and walking are important options for increasing functional mobility and balance function, and yoga might be particularly effective for decreasing depressive symptoms and cognitive impairment and improving activities of daily living in PD. The potential optimal dose of yoga for enhancing motor ability in PD patients is 60-min sessions, two times a week. Registration: PROSPERO CRD42021224823.
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Affiliation(s)
- Chunxiao Wu
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Guangdong, China.,The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yingshan Xu
- Clinical Medical of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hongji Guo
- Clinical Medical of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunzhi Tang
- Clinical Medical of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dongfeng Chen
- The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Meiling Zhu
- Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Guangdong, China
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22
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Meta-Analysis of the Effect of Yoga Practice on Physical Fitness in the Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111663. [PMID: 34770176 PMCID: PMC8583600 DOI: 10.3390/ijerph182111663] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 12/02/2022]
Abstract
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.
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23
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Marmamula S, Kumbham TR, Modepalli SB, Barrenkala NR, Yellapragada R, Shidhaye R. Depression, combined visual and hearing impairment (dual sensory impairment): a hidden multi-morbidity among the elderly in Residential Care in India. Sci Rep 2021; 11:16189. [PMID: 34376737 PMCID: PMC8355224 DOI: 10.1038/s41598-021-95576-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/20/2021] [Indexed: 12/20/2022] Open
Abstract
To report the prevalence of depression and its association with combined visual (VI) and hearing impairment (HI) in the elderly in residential care in India. Participants aged ≥ 60 years were recruited from 41 homes. Data on personal and sociodemographic information were obtained. Visual acuity was measured using the logMAR chart. Patient Health Questionnaire (PHQ-9) was used to assess depression, and the Hearing Handicap Inventory for the Elderly Screening (HHIE) was administered to assess hearing status. Data of all 867 eligible elderly participants were analysed. The mean age of the participants was 74.2 years (standard deviation: 8.2 years) and included 537 (61.9%) women and 117 (13.5%) participants who had no education. The prevalence of depression was 60.0% (95% CI: 45.2-73.4) in the elderly with combined VI and HI compared to 20.9% (95% CI:14.4-28.8) among those with VI only and 37.8% (95% CI: 26.6-46.5) among those with HI only. On multiple logistic regression analyses, depression was approximately 5 times higher among the participants with DSI after adjusting for other covariates. Six out of ten elderly with combined HI and VI had depression highlighting the need for screening and referral when elderly present with combined vision and hearing loss.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India.
- Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, 500034, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Satya Brahmanandam Modepalli
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Navya Rekha Barrenkala
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Ratnakar Yellapragada
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, 500034, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Rahul Shidhaye
- Pravara Institute of Medical Sciences, Loni, Maharashtra, India
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24
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Karri R, Bhavanani A, Ramanathan M, Mopidevi V. Yoga therapy in psychiatry: Myths and misconceptions. ARCHIVES OF MENTAL HEALTH 2021. [DOI: 10.4103/amh.amh_64_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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25
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Chobe S, Patra SK, Chobe M, Metri K. Effect of integrated Yoga and Ayurveda Rasayana on cognitive functions in elderly with mild cognitive impairment. J Ayurveda Integr Med 2020; 13:100373. [PMID: 33349568 PMCID: PMC9034459 DOI: 10.1016/j.jaim.2020.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 10/21/2020] [Accepted: 11/17/2020] [Indexed: 12/15/2022] Open
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