The basis and application of yoga for healthy aging

Shirley Telles, MBBS, Ph.D. [email protected]

Director

Patanjali Research Foundation www.patanjaliresearchfoundation.com

Patanjali Yogpeeth, Haridwar, India

The basis and application of yoga for healthy aging

Copyright to PYP Haridwar, India

THE ANCIENT SAGES OF INDIA


Gunanetanatitya treendehi dehasamudbhawan Janma mrityu jara dukhair vimukto amritamashnute. When one is able to transcend the states associated with the material body, that is birth, old age and decay and their distress, then one can enjoy nectar even in this life.

(Bhagavad Gita Chapter XIV, Verse 20)

Na tasya rogo na jara na mrityu praptasy yogagnimayam shariram

He becomes free from diseases, aging and mortality, who has made his body burnt in fire of yoga.

(Shwetashwataropnishad Chapter II, Verse 12)

na jäyate värddhakaà ca jvarä naiva prajäyate bhavetsvacchandadehaçca kaphadosaà nivärayet||60|| Old age never comes to him …who practices the kriyas.. and decrepitude never disfigures him. The body becomes healthy, elastic, and disorders of phlegm are destroyed.

(Gheranda Samhita, Chapter I, Verse 60) Copyright to PYP Haridwar, India

SOURCES: CONTEMPORARY RESEARCH

1.  A review of 8 databases: CINAHL Plus with full text, Cochrane library, Embase, Medline, PsycInfo, PsycArticles, Natural Standard and Web of Science. Incuded those studies where yoga was used as an intervention for persons aged >60 years; included those with existing ill-health. Total 31 publications

2. A review of 5 databases: CINAHL, PsycInfo, Medline/PubMed,

Scopus and Web of Science. Included RCTs on persons aged > 55 years, who were healthy. Total 20 publications

REFERENCES: 1.  Complementary, and Alternative Interventions in Mental Health and Aging, Oxford

University Press, 2016

2.  The Principles and Practice of Yoga in Health Care, 2016, Handspring Publishing


CHANGES WHICH MAY OCCUR WITH AGING * Physical * Cognitive * Psychological & Social

•  & Cellular aging which can be influenced by the above


PHYSICAL CHANGES

1.  Altered sensation & Altered perception 2.  Musculoskeletal changes 3.  Cardiovascular changes 4.  Respiratory functions alter 5.  Immune system weakens 6.  Cognitive functions alter 7.  Changes in sleep structure

How inevitable are these changes?


SENSATION, PERCEPTION: VISUAL STIMULI (Age range 20 to 59 years)

Improves perception of:

1.  Optical illusions 2.  Flickering light 3.  Depth (3D)

•  Perceptual and Motor Skills, 2012 •  Indian Journal of Physiology and Pharmacology,

1997 a, b •  Journal of Indian Psychology, 1995, 1999, 2002


RESPONSE TO AUDITORY STIMULI (18 to 59 years)

1. Reduced latency (medial geniculate) 2. Increased amplitude (medicial geniculate, Heschl’s gyrus)

EEG and Clinical Neuroscience 2009, 2012, 2014


A STUDY IN PERSONS > 60 years of age • Audiometry findings after 6m of yoga – no change in persons > 60 years;

• A 3 arm randomized trial (yoga, ayurveda, wait list control; n= 23 each)

Indian J Medical Research, 2005

(Decreases with age: s, h, f are high-frequency sounds that range from 1,500 to 6,000 Hertz



MUSCULO-SKELETAL CHANGES WITH AGING

1.  Muscles weaken, muscles lose their tone

2.  Body movements become slow

3.  Bones reduce in density

4.  Joints may stiffen, get painful

5.  Overall height may reduce; chest appear barrel-like


MOTOR SKILLS (age range: 18 – 59 years)

YOGA IMPROVES: 1.  Hand steadiness 2.  Tweezer dexterity 3.  Hand grip, leg and back

strength 4. Repetitive motor activity

References: 1. Medical Science Monitor, 2015, 2012 2. Perceptual and Motor Skills, 1993, 2009, 2011 3. Indian Journal of Physiology and Pharmacology, 1994, 1997, 1999 a,b & 2001,

2014 Copyright to PYP Haridwar, India

CHANGES IN MUSCLE FUNCTIONING IN OLDER PERSONS AFTER YOGA PRACTICE (3 months)

1.  Increase in muscle strength and endurance

2.  Increase in active range of movement

PRECAUTIONS

REFERENCES: 1.  The Principles and Practice of Yoga in Health Care, 2016 2.  Complementary, Alternative and Interventions in Mental Health and Aging, 2016


AGING: GAIT AND BALANCE

Six months of yoga improved: 1. Flexicurve kyphosis angle 2. Kyphosis index

(Kyphosis = A ‘hump’)

Three months of yoga improved: 1.  Standing balance 2.  One-legged stance with EC 3.  With decreased falls 4.  Walking speed

REFERENCES: 1.  The Principles and Practice of Yoga in Health Care, 2016 2.  Complementary, and Alternative Interventions in Mental Health and Aging, Oxford

University Press, 2016 Copyright to PYP Haridwar, India

Presbycardia = normal changes in the healthy heart •  Stroke volume •  Cardiac output •  Left ventricle wall thickens - As much as 50% by age 80 •  Left atrium enlarges ( to compensate)

Normal changes of aging: the Cardiovascular System


A REVIEW OF YOGA FOR HYPERTENSION: 22 STUDIES FROM 11 BIBLIOGRAPHIC DATABASES

Inclusion: Yoga used as an intervention for hypertension in people over 60 years of age

SUMMARY: Yoga without a control/alternate intervention was associated with a significant decrease in systolic BP (-7.96 mm Hg) and diastolic BP (-5.52 mmHg)

Over-all the quality of studies was not adequate to be conclusive

Reference: Complementary, and Alternative Interventions in Mental Health and

Aging, Oxford University Press, 2016


CHANGES IN THE RESPIRATORY SYSTEM WITH AGING

•  Reduction in respiratory activity

•  Increased rigidity of the thoracic cage

•  Kyphosis

•  Increased anterior-posterior diameter of the chest

•  Blunted cough reflex, reduced cilia

•  Lung expansion is reduced

Turning to the side &

propped up


YOGA AND THE RESPIRATORY SYSTEM IN HEALTHY SENIORS

1.  Three months of yoga practice reduced heart and breath rate (3 months) 2. Yoga significantly increased VE, VC, MIP and MEP (3 months) 3. In persons with COPD decrease in DD, better self-reported

functioning, 6-min walk (3 months)

REFERENCES: 1.  The Principles and Practice of Yoga in Health Care, 2016 2.  Complementary, and Alternative Interventions in Mental Health and Aging,

Oxford University Press, 2016


THE FUNCTIONING OF THE CARDIOVASCULAR SYSTEM AND THE RESPIRATORY SYSTEM ARE INTER-REATED

Cardio-respiratory efficiency can improve with yoga


Effects of aging on the Immune System

•  Cell-mediated responses decrease (T cell mediated) •  Humoral responses decrease (antibody mediated) •  T–cell function is altered •  B-cells produce less antibodies

CHANGES WITH AGING

BAD NEWS GOOD

NEWS

Immune system weakens

Most anti-bodies formed are stored


1.  34 RCTs indicate that Tai Chi, Qi Gong, meditation, and Yoga, both short- and long-term, appear to reduce markers of inflammation

2.  18 published RCTs evaluated inflammatory measures, reported that 7 to 16 weeks of mind-body interventions significantly reduced C-reactive protein, and produced a small but nonsignificant reduction of IL-6, as well as a negligible effect on TNF-α

3. 21 trials showed negligible effects on CD4 count and natural

killer cell counts

MIND-BODY PRACTICE, THE IMMUNE SYSTEM & AGING NO STUDIES ON PERSONS >60 YEARS

PLoS ONE. 2014; 9(7): e100903 (A meta-analyses)


THE MOST COMMON COGNITIVE CHANGES ASSOCIATED WITH NORMAL AGING

1.  Short-term memory is relatively unaffected (from a few minutes to a few days)

2.  Episodic or declarative long term memory is affected (‘what’ – facts and events)

3.  Implicit long-term memory (‘how’ – tying shoe laces) is essentially unaffected by aging

4.  Cognitive inflexibility


NEUROCOGNITIVE BENEFITS SEEN WITH YOGA IN OLDER PERSONS

After 8 weeks of yoga: 1. Better working memory; E – prime 2.0, serial –n-back task 2. Better mental set shifting and flexibility; E – prime 2.0



CHANGES IN THE NERVOUS SYSTEM WITH AGING

1.  Reduced cerebral blood flow & metabolism, reduced nerve cells

2.  Slower reflexes, delayed responses & changes in balance; INCREASED RISK OF FALLS

3.  Changes in sleep patterns


NORMAL CHANGES IN SLEEP ARCHITECTURE AS WE AGE

1.  Delayed sleep onset 2.  Increased wakefulness after sleep onset 3.  Perception of and Actual - Lighter sleep 4.  Decreased sleep efficiency 5.  Increased Stage 1 sleep 6.  Decreased slow wave sleep 7.  Increased fragmentation of sleep


CHANGES IN SLEEP STRUCTURE IN SENIORS FOLLOWING YOGA

After 6 months of yoga community-dwelling seniors showed (subjective): 1.  Decrease in time for sleep onset 2.  An increase in total number of hours slept 3.  An increased feeling of being rested in the morning



The ancient Indian Vedic system

PSYCHO-SOCIAL FACTORS AND AGING


INDIA: TWO EXTREMES


SOCIAL AND PSYCHOLOGICAL CHANGES ASSOCIATED WITH AGING

1.  With the onset of old age people may have to confront regrets such as disappointment in their own life/that of their children

2.  Frustration if they have not achieved what they sought to achieve

3.  Ideal – embrace the new phase as a time to practice hobbies, creativity, grow in Spirituality


PSYCHOLOGICAL CHANGES ASSOCIATED WITH YOGA PRACTICE IN SENIORS

1.  Improved mood 2.  Increased self-confidence 3.  Increased life satisfaction

------------------------------------------------------------------------------------------ SOCIALLY 1.  Improved family relations 2.  Better sex life 3.  Less loneliness



SPIRITUALITY AND LONGEVITY

A meta-analysis of 29 articles concluded seniors who scored higher on religious involvement were almost 30 % less likely to have died than those with lower scores – accounted for: health, gender, race, health behaviors & social support.



Telomeres are protective pieces of DNA material at the ends of chromosomes Evidence clearly shows that people with long telomeres age healthier and live longer. Every time a cell divides, the telomeres get shorter. Without telomeres, the protective caps at the chromosome - the part containing genes essential for life - would get shorter each time a cell divides. The only way to lengthen telomeres is through the activation of an enzyme called telomerase.

Many interventions slow attrition.

ALL THESE FACTORS INFLUENCE CELLULAR AGING



YOGA AND CELLULAR AGING

1.  Reduction in stress-related cellular aging by increasing telomerase activity.

2.  Reduction in effects of chronic inflammation on the cells

3.  Preserves telomere length

REFERENCES: 1.  The Principles and Practice of Yoga in Health Care, 2016 2.  Complementary, Alternative and Interventions in Mental Health and Aging,

2016 Copyright to PYP Haridwar, India

AYURVEDA RATHER THAN YOGA HAS BEEN RESEARCHED MORE THOROUGHLY: PHYSICAL APPEARANCE AND AGING


HOW SHOULD AGE BE CONCEPTUALIZED?

• Chronological age – number of years since birth

• Biological age – based on functional capacity of organs • Psychological age – adaptive capacity compared to those of the same chronological age • Social age – roles in society expected based on age


MEDITATION AND CHRONOLOGICAL VS. BIOLOGICAL AGE

Practitioners of TM: Experienced meditators had a biological age 12 years less than their chronological age.

REFERENCE: Complementary, and Alternative Interventions in Mental Health and Aging, Oxford University Press, 2016


REFERENCE: Complementary, and Alternative Interventions in Mental Health

and Aging, Oxford University Press, 2016



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The basis and application of yoga for healthy aging