Yoga may improve markers of frailty in older adults

1. In this systematic review, yoga was associated with improvements in gait speed and lower-extremity strength in older adults.

2. However, when yoga was compared to active interventions, such as tai chi and regular exercise, there was no significant improvement in frailty markers.

Evidence Rating Level: 1 (Excellent)

The practice of yoga has demonstrated benefits on various health parameters, including breath control, lung function, and cognition. Although studies have shown that yoga improves balance and mobility in older adults, currently no reviews have examined the effects of yoga on frailty in older adults. As a result, the objective of the present systematic review was to synthesize the evidence regarding the effects of yoga-based interventions on frailty markers in older adults.

Of 6349 identified records, 33 (n=2384 participants) studies were included from various databases from 2006-2022. Studies were included if they were randomized controlled trials that investigated the effects of yoga on one or more domains of frailty, investigated a yoga-based intervention that included at least 1 session of physical postures, and had a mean participant age of 65 years or older. Studies were excluded if they evaluated mindfulness-based stress reduction. The review was performed using PRISMA guidelines. Risk of bias was assessed using the Cochrane revised tool for assessing risk of bias in randomized trials (RoB 2). The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The primary outcome was the impact of yoga on markers of frailty in older adults.

The results demonstrated that, compared to inactivity or education alone, yoga-based interventions were effective at improving gait speed, lower-extremity strength, and lower-extremity endurance in older adults. However, there was less evidence to suggest the effectiveness of yoga on improving other frailty markers, such as balance and handgrip strength. When yoga was compared to an active control group (e.g., formal exercise or tai chi), there was no significant difference in frailty markers. Despite these results, the study was limited by the heterogeneity in the study designs and yoga styles. Nonetheless, the findings of the present study suggested that yoga may be an effective modality in improving frailty markers in older adults.

Click to read the study in Annals of Internal Medicine

Image: PD

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