Categorized | Family Care, Health studies

Yoga May Help To Prevent Frailty In Older Adults

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Yoga improved gait speed and lower extremity strength in inactive older people, according to a review of 33 randomized controlled trials (RCTs).

Frailty, which can emerge from a variety of causes, is estimated to affect up to half of individuals over age 80. Frailty can make it more difficult to live independently, decrease quality of life, and increase risk of death. With the world’s population aging, frailty is a significant geriatric concern, but its complexity makes it difficult to treat or prevent.

Yoga is a mind-body practice that involves physical poses as well as other elements such as breathing and meditation, and it has previously been shown to improve balance, mobility, and mental wellbeing in older adults. To investigate whether yoga can improve frailty researchers at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, and other collaborators reviewed randomized controlled studies of yoga that included a total of 2,384 participants over 65. Their findings, published in Annals of Internal Medicine, suggest that yoga boosts essential physical capabilities, like walking speed and the ability to rise from a chair, which are associated with reduced frailty and increased lifespan.

“There are many contributing factors to frailty, such as difficulties with walking and balance, cognitive impairment and certain chronic conditions. When you look at a whole person, especially an older person, there may be a number of difficulties that each contribute to frailty,” said first author Julia Loewenthal, MD, of the Division of Aging. “Since yoga is an integrative practice that impacts multiple areas of health, it may be effective for preventing a syndrome like frailty, which has multiple causes.”

Yoga’s benefit to physical health has never been assessed against validated definitions of frailty, such as the Fried physical phenotype and Rockwood cumulative deficit models. Therefore, the authors reviewed studies that reported how yoga affected individual metrics of frailty included in these models, like gait or walking speed, balance, handgrip strength, lower extremity strength and endurance, and various multicomponent physical performance measures.

Across the 33 randomized controlled studies in the review, improved walking speed was found to have the strongest association with a yoga intervention compared to control groups who were inactive or who received educational interventions. The authors emphasized the clinical importance of this finding, given prior research showing that slower walking speeds are connected to higher risk of death in older adults.

Similarly, the authors were encouraged by the finding that yoga may improve leg strength, which affects daily activities like rising from a chair or bed. There was less evidence that yoga improved balance; however, the authors note that some of the yoga practices in the reviewed studies were chair-based programs, and therefore may not have offered the same benefit to balance as standing poses. Handgrip strength, another metric of frailty, was not found to improve with yoga practice. Yoga was also not shown to offer benefits for frailty that extend beyond those associated with exercise or other mind-body practices like tai chi.

The authors note several limitations to the study, including the small sample sizes of many trials and the lack of consistency in the types of yoga practices evaluated. Their findings suggest that Iyengar-based styles of practice, which are customizable and amenable to the use of props, may be especially effective for frailty prevention.

Going forward, the researchers hope to use validated definitions of frailty, such as the Fried physical phenotype or Rockwood cumulative deficit test, to assess the effect of a yoga intervention on frailty in older adults. Determining whether yoga is more effective as an early intervention for frailty at younger ages is also of interest to the researchers, who note that the mean age of the participants was 72 years.

“There’s a potential for movement-based mind-body practices to be really helpful for promoting healthy aging over the lifespan because they provide a physical and cognitive health benefit, but also because they have a spillover effect that can lead to having a healthier lifestyle overall,” Loewenthal said.

“It may be helpful to get involved in a healthy practice like this at a younger age, but with that said, we still saw clinically meaningful results in an older population. It’s never too late to start a yoga practice or exercise regimen to help with your overall health status in your later years.”

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