Alzheimer’s disease is a progressive form of dementia that causes brain cells to degenerate and waste away, resulting in problems with memory, thinking, language, and behavior. According to the Alzheimer’s Association, 5.8 million Americans age 65 and older are living with Alzheimer’s disease. By 2050 the number is expected to rise to 14 million.
There is no cure for Alzheimer’s and its devastating effects. But incorporating a complementary approach, such as yoga, into Alzheimer's care, may help with some of the symptoms and challenges of the disease.
“Research around yoga and its impact on Alzheimer’s disease is somewhat limited and far from conclusive,” says Ruth Drew, MS, LPC, a director of information and support services for the Alzheimer’s Association in Chicago. “But there is anecdotal evidence to suggest that yoga has potential benefits that could help in reducing stress, calming agitation, and improving overall mood,” she adds. Yoga can provide a safe, social physical activity that may help alleviate the isolation that Alzheimer's patients can often feel.
“Yoga is safe, it can reduce stress levels, and it’s good for mental health,” notes Jonathan Graff-Radford, MD, a behavioral neurologist at Mayo Clinic in Rochester, Minnesota. “While we don’t know the direct effect it may have on cognitive impairment, yoga offers significant benefits, including being good for your balance, so we do suggest it to patients.”
Yoga: An Increasingly Popular Mind-Body Intervention Among Older Adults
Modern yoga incorporates poses, breathing exercises, and meditation. It's often described as a mind-body intervention (MBI), meaning it focuses on the relationship between the brain, mind, body, and behavior and their effect on health and disease. According to the National Center for Complementary and Integrative Health (NCCIH), research suggests that yoga may reduce stress, support good health habits, and improve mental-emotional health, sleep, and balance.
The National Center for Health Statistics (NCHS) notes that yoga is the most common complementary health approach used by adults in the United States. Among older adults, yoga has grown in popularity with 6.7 percent of U.S. adults aged 65 and over practicing yoga in 2017 compared with 3.3 percent in 2012, according to the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS). For individuals living with Alzheimer’s or other forms of dementia, yoga is a relatively safe form of movement with low risk for injury.
What Does Yoga for People With Alzheimer's Involve?
Most yoga for Alzheimer patients involves gentle movements performed in a slow, easy manner. Classes tend to be shorter than a typical yoga session, generally lasting anywhere from 10 to 30 minutes.
Sequences can be tailored to an individual's physical capabilities and motor skills. Instructors never force movements and participants are encouraged to do what they can. This can help an individual with Alzheimer's feel a sense of self-determination and empowerment.
For those with moderate or severe dementia, or those who may have issues with balance or are unable to sit on the floor or mat, chair yoga may be a good option. In chair yoga, you either do the poses from a seated position or stand using the chair as support. Basic yoga poses, such as Mountain pose, Prayer pose, or any of the various Warrior poses, are adapted so that you can do them from a seated position for chair yoga.
Seated or standing, you can still benefit from improved posture, increased flexibility of the hips and strengthening of legs, ankles, and feet. Yoga classes designed for individuals with Alzheimer's often emphasize the mindfulness teachings of yoga in addition to the physical movements.
How Does Yoga Lower Stress?
The potential risks are low, but what about the possible benefits of yoga for those with Alzheimer's? The jury is still out on whether practicing yoga can actually delay or slow or the progression of Alzheimer’s disease. But yoga does help with stress, which is known to have detrimental effects on the body. And there’s increasing evidence, notes a review of studies published in February 2018 in the journal Neurobiology of Stress, that stress can have a harmful effect on the progression of neurodegenerative diseases like Alzheimer’s.
Stress activates the body’s fight-or-flight response. This triggers a rise in heart rate, blood pressure, and the release of stress hormones, all of which have negative effects on your cardiovascular system.
Yoga helps activate the opposite effect, known as the rest-and-digest response, when your parasympathetic nervous system essentially acts as a brake, dampening the stress response triggered by the cascade of stress hormones. Over time, regular yoga practice fosters the growth of this relaxation response, enabling you to be less reactive to stress.
Can Yoga Improve Brain Function?
Physical activity is not only important for overall wellness but it’s associated with a lower risk of cognitive decline. Several studies, such as one published in January 2018 in the Journal of the American Geriatrics Society, have suggested that exercise, particularly aerobic exercise, may delay the decline in cognitive function that occurs in individuals who are at risk of or who have Alzheimer’s disease. While it is not fully understood how exercise lowers dementia risk, scientists believe that exercise leads to better vascular health and thus better brain health. It’s thought that exercise directly benefits brain cells by increasing blood and oxygen flow in the brain. While most yoga, particularly the gentle forms geared toward people with Alzheimer's, is not intense enough to be considered an aerobic exercise, there is some evidence that it may still offer similar cognitive benefits.
A recent study review, published in December 2018 in the International Journal of Environmental Research and Public Health, concluded that mind-body exercise (such as yoga and tai chi) may be a safe and effective intervention for enhancing cognitive function among people aged 60 years or older. Four of the studies included in the meta-analysis specifically involved yoga interventions. One included study, published in January 2017 in the Journal of Alternative and Complementary Medicine, found that yoga practice that involves postures, breathing, and meditative exercises leads to improved attention and information processing (time required to perform a task) abilities. However, the study authors point out that further research is needed to make a more conclusive statement.
Another review, published in 2019 in the journal Brain Plasticity, found evidence that yoga enhances many of the same brain structures and functions that benefit from aerobic exercise. Researchers reviewed 11 studies and found that yoga appears to have a positive effect on key areas of the brain responsible for memory and information processing, as well as emotional regulation. For example, practicing yoga appears to increase the volume of the hippocampus, a part of the brain known to shrink with age. The hippocampus is also the structure that is first affected in dementia and Alzheimer’s disease.
The study authors suspect that enhancing emotional regulation and reducing stress is a key to yoga’s positive effects on the brain.
While scientists don’t yet fully understand the mechanisms, these findings suggest that “Alzheimer’s yoga” may be a brain healthy alternative form of physical activity for older adults, especially those who may have disabilities or symptoms that prevent them from performing more vigorous forms of exercise.