Accepted Manuscript

Yoga and meditation can help improve cognitive functioning in older

adults with mild cognitive impairment and dementia

Helen Lavretsky M.D., M.S.

PII: S1064-7481(18)30570-0
DOI: https://doi.org/10.1016/j.jagp.2018.11.002
Reference: AMGP 1129

To appear in: The American Journal of Geriatric Psychiatry

Received date: 15 November 2018

Accepted date: 18 November 2018

Please cite this article as: Helen Lavretsky M.D., M.S. , Yoga and meditation can help improve cogni-
tive functioning in older adults with mild cognitive impairment and dementia, The American Journal of
Geriatric Psychiatry (2018), doi: https://doi.org/10.1016/j.jagp.2018.11.002

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Yoga and meditation can help improve cognitive functioning in older adults

with mild cognitive impairment and dementia.

By Helen Lavretsky, M.D., M.S.

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Corresponding author:

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Helen Lavretsky, MD, MS
Professor of Psychiatry

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Semel Scholar in Integrative Mental Health
Director, Late life mood, stress, and wellness program

Semel Institute for Neuroscience and Human Behavior

David Geffen School of Medicine at UCLA
Los Angeles, CA, USA
Address: 760 Westwood Plaza, 37-456
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Los Angeles, CA 90095
Phone 310- 794-4619
Fax 310- 206-4399
Email: hlavrets@ucla.edu
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This work was supported by the NIH grants AT008383, AT009198, MH097892, and
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Alzheimer’s Research and Prevention Foundation to Dr. Lavretsky

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The use of mind-body practices like meditation and yoga is on the rise in the US

according to the 2017 National Health Interview Survey (NHIS), published by NCCIH

and the National Center for Health Statistics (NCHS) (1). The use of meditation more

than tripled among adults, with 14.2% of people age 18 and older reporting that they had

meditated during the past year in 2017, compared with 4.1% in 2012. The proportion of

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U.S. adults who reported practicing yoga increased from 9.5% in 2012 to 14.3% in 2017

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(1)

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Aging Baby Boomers are more likely to use mind-body and other complementary and

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integrative medicine (CIM) approaches (2). Groden et al., 2017 reported that 23% of
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older adults used CIM. Baby Boomers were more likely than pre-Boomers to report using

different CIM modalities. A growing body of research supports the use of mind-body
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therapies as effective, holistic approaches to healthy aging. Most of the mind-body

approaches are rooted in ancient Eastern traditions that focus on establishing balance
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between mind, body and spirit to improve mental and physical well-being. Particularly

popular approaches include mindful movement (yoga, qigong, and tai chi) and
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mindfulness-based meditation, each of which rank among the top five most frequently
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utilized complementary health approaches in the Unites States [3]. Such approaches can

be used alone or in conjunction with Western medicine, and have been shown to reduce
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side effects associated with pharmacological treatment [4].

Current estimates of the proportion of people aged 60 years and older with MCI range

from 16-20%, and about 10% of those 65 years and older suffer from Alzheimer’s
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disease [5]. As the proportion of individuals in this age group increases, the incidence of

cognitive impairment is also expected to rise. A few mind-body practices have shown

promise for improving cognitive functioning in geriatric populations. It is a rapidly

growing field that is attracting interest of researchers and clinicians working with older

adults, and neuroscientists because of the demonstrated potential of the mind-body

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practices and exercises to improve neuroplasticity of the aging brain and improve

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memory, cognition, mood and quality of life, an potentially delay or reverse cognitive

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decline (5-8).

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Brenes et al (9) provides a literature review to examine the impact of yoga on persons
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with MCI and dementia and discusses some of the proposed mechanisms. Across

identified eight studies, the authors found that yoga and meditative practices had
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beneficial effects on cognitive functioning, particularly on attention and verbal memory.

Some proposed mechanisms for improved cognitive functioning included improved

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sleep, mood, and neural connectivity. The authors noted limitations of the existing

studies, including a lack of intervention details, variability in the frequency, duration and
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components of the yoga interventions, as well as various underlying etiologies of

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cognitive impairment. The authors concluded that recommending yoga to persons with

MCI or dementia can provide a potentially beneficial complementary health approach.

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In conclusion, the interest in mind-body approaches for various disorders of aging is

growing with the increased acceptance of such health and wellbeing- oriented

interventions. This trend is supported by a growing body of research evidence supports

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the use of meditation, yoga, tai chi, and Qigong as minimally-invasive, cost-effective

approaches for the management of late-life mood and cognitive disorders. Continued

research in this area will promote the integration of mind-body therapies into mainstream

clinical practice and help to alleviate the increased chronic health burden of an aging

population. Further work is needed to determine if yoga has a differential effect on

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cognition based on the underlying pathophysiology of the cognitive impairment. Because

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of the growing number of older adults who practice yoga and Tai Chi, physical ability-

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based modifications to these practices are typically included in teacher or physical

therapist training such as restorative yoga, yin yoga, “Silver yoga,” or chair- based

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versions of yoga and Tai Chi that are not as demanding or difficult to perform for
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individuals with physical limitations. Clinicians may consider recommending yoga to

persons with MCI or dementia depending on their acceptance of such interventions and
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physical abilities to participate.

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References

1. NCCIH website accessed on 11/15/2018

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https://content.govdelivery.com/accounts/USNIHNCCIH/bulletins/21b2500
2. Lavretsky H. Complementary, Alternative, and Integrative Medicine Use is Rising
among Aging Baby Boomers. Am J Geriatr Psychiatry. 2017
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Dec; 25(12):1402-1403. doi: 10.1016/j.jagp.2017.08.004. Epub 2017 Aug 30. PubMed

PMID: 28939285.
3: Groden SR, Woodward AT, Chatters LM, Taylor RJ. Use of Complementary and
Alternative Medicine among Older Adults: Differences between Baby Boomers and Pre-
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Boomers. Am J Geriatr Psychiatry. 2017 Dec;25(12):1393-1401.

doi:10.1016/j.jagp.2017.08.001. Epub 2017 Aug 12. PubMed PMID: 28958866; PubMed
Central PMCID: PMC5694360.
4. Laird KT, Paholpak P, Roman M, Rahi B, Lavretsky H. Mind-Body Therapies for
Late-Life Mental and Cognitive Health. Curr Psychiatry Rep. 2018 Jan 25;20(1):2. doi:
10.1007/s11920-018-0864-4. Review. PubMed PMID: 29372339.
5. Wayne, P.M., et al. (2014). Effect of tai chi on cognitive performance in older adults:
systematic review and meta-analysis. Journal of the American Geriatrics Society, 62(1),
25-39. doi: 10.1111/jgs.12611
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6. Lenze, E.J., et al. (2014). Mindfulness-based stress reduction for older adults with
worry symptoms and co-occurring cognitive dysfunction. Int J Geriatr Psychiatry,
29(10), 991-1000. doi: 10.1002/gps.4086
7. Eyre, H.A., et al. (2017). A randomized controlled trial of Kundalini yoga in mild
cognitive impairment. International psychogeriatrics, 29(4), 557-567.
8. Lautenschlager, N.T., K. Cox, and E.V. Cyarto. (2012). The influence of exercise on
brain aging and dementia. Biochimica et Biophysica Acta (BBA)-Molecular Basis of
Disease, 1822(3), 474-481.
9. Brenes GA, Sohl S, Wells RE, Befus D, Campos CL, Danhauer SC. The Effects of

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Yoga on Patients with Mild Cognitive Impairment and Dementia: A Scoping Review.
Am J Geriatr Psychiatry. 2018 Oct 25. pii: S1064-7481(18)30534-7. doi:

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10.1016/j.jagp.2018.10.013. [Epub ahead of print] PubMed PMID: 30413292.

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