The Effects of Yoga on Physical Functioning and Health Related Quality of Life in Older Adults: A Systematic Review and Meta-Analysis
Publication: The Journal of Alternative and Complementary Medicine
Volume 18, Issue Number 10
Abstract
Objective: The goal was to review systematically the comparative effectiveness of yoga, compared with other exercise interventions, for older adults as shown on measures of health and physical functioning.
Design: This was a systematic review with both narrative synthesis and meta-analysis.
Data sources: Searches were conducted in MEDLINE®/PUBMED, PSYCINFO, CINAHL, Web of Science, and SCOPUS; bibliographies of selected articles; and one systematic review on the effects of yoga on cardiovascular disease.
Methods: Original studies from 1950 to November 2010 were sought, evaluating the effects of yoga on older adults. The search was restricted to randomized controlled trials of yoga in subjects ≥age 60, and published in English. Data were extracted and evaluated regarding setting, population size and characteristics, intervention type and duration, comparison group, outcome assessment, data analysis, follow-up, key results, and the quality of each study according to specific predetermined criteria.
Results: The search yielded 18 eligible studies (N=649). The studies reported on older adults across a range of settings, intervention intensity, and outcome measures. The majority of the studies had<35 participants (range 9–77). Quantitative and qualitative synthesis of the studies suggested that the benefits of yoga may exceed those of conventional exercise interventions for self-rated health status, aerobic fitness, and strength. However, the effect sizes were modest, and the evidence was mixed for yoga's effect on depression, sleep, and bone-mineral density. Studies did not find an effect on cognition.
Conclusions: Small studies with mixed methodological quality suggested that yoga may be superior to conventional physical-activity interventions in elderly people. The precision of the estimates remains low. Larger studies are necessary to define better the intersection of populations, settings, and interventions in which yoga is most beneficial.
Get full access to this article
View all available purchase options and get full access to this article.
References
1.
Carlson SAFulton JESchoenborn CA et al. Trend and prevalence estimates based on the 2008 Physical Activity Guidelines for AmericansAm J Prev Med201039305-313. 1. Carlson SA, Fulton JE, Schoenborn CA, et al. Trend and prevalence estimates based on the 2008 Physical Activity Guidelines for Americans. Am J Prev Med 2010;39:305–313.
2.
Espinoza SWalston JD. Frailty in older adults: Insights and interventionsCleve Clin J Med2005721105-1112. 2. Espinoza S, Walston JD. Frailty in older adults: Insights and interventions. Cleve Clin J Med 2005;72:1105–1112.
3.
Rockwood KMitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailtyClin Geriatr Med20112717-26. 3. Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med 2011;27:17–26.
4.
Hackstaff L. Factors associated with frailty in chronically ill older adultsSoc Work Health Care200948798-811. 4. Hackstaff L. Factors associated with frailty in chronically ill older adults. Soc Work Health Care 2009;48:798–811.
5.
American College of Sports MedicineChodzko-Zajko WJProctor DN et al. American College of Sports Medicine position stand: Exercise and physical activity for older adultsMed Sci Sports Exerc2009411510-1530. 5. American College of Sports Medicine; Chodzko-Zajko WJ, Proctor DN, et al. American College of Sports Medicine position stand: Exercise and physical activity for older adults. Med Sci Sports Exerc 2009;41:1510–1530.
6.
Physical Activity Guidelines Advisory Committee report2008. To the Secretary of Health and Human Services. Part A: Executive summaryNutr Rev200967114-120. 6. Physical Activity Guidelines Advisory Committee report, 2008: To the Secretary of Health and Human Services. Part A: Executive summary. Nutr Rev 2009;67:114–120.
7.
Miszko TACress MESlade JM et al. Effect of strength and power training on physical function in community-dwelling older adultsJ Gerontol A Biol Sci Med Sci200358171-175. 7. Miszko TA, Cress ME, Slade JM, et al. Effect of strength and power training on physical function in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2003;58:171–175.
8.
National Institute on AgingExercise and Aging–Your Everyday Guide from the National Institute on Aging, Publication of the NationalInstitute on AgingGaithesburg, MD208982009. 8. National Institute on Aging. Exercise and Aging–Your Everyday Guide from the National Institute on Aging, Publication of the National. Institute on Aging, Gaithesburg, MD 20898, 2009.
9.
Barnes PMBloom BNahin RL. Complementary and alternative medicine use among adults and children: United States, 2007Natl Health Stat Report2008121-23. 9. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report 2008;12:1–23.
10.
Birdee GSLegedza ATSaper RB et al. Characteristics of yoga users: Results of a national surveyJ Gen Intern Med2008231653-1658. 10. Birdee GS, Legedza AT, Saper RB, et al. Characteristics of yoga users: Results of a national survey. J Gen Intern Med 2008;23:1653–1658.
11.
Centers for Disease Control and Prevention. Prevalence of self-reported physically active adults—United States, 2007MMWR Morb Mortal Wkly Rep2008571297-1300. 11. Centers for Disease Control and Prevention. Prevalence of self-reported physically active adults—United States, 2007. MMWR Morb Mortal Wkly Rep 2008;57:1297–1300.
12.
Chen KMChen MHChao HC et al. Sleep quality, depression state, and health status of older adults after silver yoga exercises: Cluster randomized trialInt J Nurs Stud200946154-163. 12. Chen KM, Chen MH, Chao HC, et al. Sleep quality, depression state, and health status of older adults after silver yoga exercises: Cluster randomized trial. Int J Nurs Stud 2009;46:154–163.
13.
Iyengar BYoga: The Path to Holistic HealthNew YorkDK Publishing2001. 13. Iyengar B, ed. Yoga: The Path to Holistic Health. New York: DK Publishing, 2001.
14.
Nguyen HTGrzywacz JGLang W et al. Effects of complementary therapy on health in a national U.S. sample of older adultsJ Altern Complement Med201016701-706. 14. Nguyen HT, Grzywacz JG, Lang W, et al. Effects of complementary therapy on health in a national U.S. sample of older adults. J Altern Complement Med 2010;16:701–706.
15.
Nahin RLBarnes PMStussman BJ et al. Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007Natl Health Stat Report2009181-14. 15. Nahin RL, Barnes PM, Stussman BJ, et al. Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. Natl Health Stat Report 2009;18:1–14.
16.
DiBenedetto MInnes KETaylor AG et al. Effect of a gentle Iyengar yoga program on gait in the elderly: An exploratory studyArch Phys Med Rehabil2005861830-1837. 16. DiBenedetto M, Innes KE, Taylor AG, et al. Effect of a gentle Iyengar yoga program on gait in the elderly: An exploratory study. Arch Phys Med Rehabil 2005;86:1830–1837.
17.
Iyengar BKSLight on Yoga—The Classic Guide to Yoga by the World's Foremost AuthorityNew DelhiHarper Collins2004. 17. Iyengar BKS. Light on Yoga—The Classic Guide to Yoga by the World's Foremost Authority. New Delhi: Harper Collins, 2004.
18.
Roland KPJakobi JMJones GR. Does yoga engender fitness in older adults? A critical reviewJ Aging Phys Act20111962-79. 18. Roland KP, Jakobi JM, Jones GR. Does yoga engender fitness in older adults? A critical review. J Aging Phys Act 2011;19:62–79.
19.
Oken BSZajdel DKishiyama S et al. Randomized, controlled, six-month trial of yoga in healthy seniors: Effects on cognition and quality of lifeAltern Ther Health Med20061240-47. 19. Oken BS, Zajdel D, Kishiyama S, et al. Randomized, controlled, six-month trial of yoga in healthy seniors: Effects on cognition and quality of life. Altern Ther Health Med 2006;12:40–47.
20.
Chen KMChen MHHong SM et al. Physical fitness of older adults in senior activity centres after 24-week silver yoga exercisesJ Clin Nurs2008172634-2646. 20. Chen KM, Chen MH, Hong SM, et al. Physical fitness of older adults in senior activity centres after 24-week silver yoga exercises. J Clin Nurs 2008;17:2634–2646.
21.
Bosch PRTraustadottir THoward P et al. Functional and physiological effects of yoga in women with rheumatoid arthritis: A pilot studyAltern Ther Health Med20091524-31. 21. Bosch PR, Traustadottir T, Howard P, et al. Functional and physiological effects of yoga in women with rheumatoid arthritis: A pilot study. Altern Ther Health Med 2009;15:24–31.
22.
Brown KDKoziol JALotz M. A yoga-based exercise program to reduce the risk of falls in seniors: A pilot and feasibility studyJ Altern Complement Med200814454-457. 22. Brown KD, Koziol JA, Lotz M. A yoga-based exercise program to reduce the risk of falls in seniors: A pilot and feasibility study. J Altern Complement Med 2008;14:454–457.
23.
Blumenthal JAEmery CFMadden DJ et al. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and womenJ Gerontol198944M147-M157. 23. Blumenthal JA, Emery CF, Madden DJ, et al. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. J Gerontol 1989;44:M147–M157.
24.
Innes KEBourguignon CTaylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: A systematic reviewJ Am Board Fam Pract200518491-519. 24. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: A systematic review. J Am Board Fam Pract 2005;18:491–519.
25.
Yogendra JYogendra HJAmbardekar S et al. Beneficial effects of yoga lifestyle on reversibility of ischaemic heart disease: Caring Heart Project of International Board of YogaJ Assoc Physicians India200452283-289. 25. Yogendra J, Yogendra HJ, Ambardekar S, et al. Beneficial effects of yoga lifestyle on reversibility of ischaemic heart disease: Caring Heart Project of International Board of Yoga. J Assoc Physicians India 2004;52:283–289.
26.
Blumenthal JAEmery CFMadden DJ et al. Effects of exercise training on cardiorespiratory function in men and women older than 60 years of ageAm J Cardiol199167633-639. 26. Blumenthal JA, Emery CF, Madden DJ, et al. Effects of exercise training on cardiorespiratory function in men and women older than 60 years of age. Am J Cardiol 1991;67:633–639.
27.
Patel CNorth WR. Randomised controlled trial of yoga and bio-feedback in management of hypertensionLancet1975ii93-95. 27. Patel C, North WR. Randomised controlled trial of yoga and bio-feedback in management of hypertension. Lancet 1975;ii:93–95.
28.
Manjunath NKTelles S. Influence of yoga and Ayurveda on self-rated sleep in a geriatric populationIndian J Med Res2005121683-690. 28. Manjunath NK, Telles S. Influence of yoga and Ayurveda on self-rated sleep in a geriatric population. Indian J Med Res 2005;121:683–690.
29.
Bowman AJClayton RHMurray A et al. Effects of aerobic exercise training and yoga on the baroreflex in healthy elderly personsEur J Clin Invest199727443-449. 29. Bowman AJ, Clayton RH, Murray A, et al. Effects of aerobic exercise training and yoga on the baroreflex in healthy elderly persons. Eur J Clin Invest 1997;27:443–449.
30.
Donesky-Cuenco DNguyen HQPaul S et al. Yoga therapy decreases dyspnea-related distress and improves functional performance in people with chronic obstructive pulmonary disease: A pilot studyJ Altern Complement Med200915225-234. 30. Donesky-Cuenco D, Nguyen HQ, Paul S, et al. Yoga therapy decreases dyspnea-related distress and improves functional performance in people with chronic obstructive pulmonary disease: A pilot study. J Altern Complement Med 2009;15:225–234.
31.
Gordon LAMorrison EYMcGrowder DA et al. Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetesBMC Complement Altern Med2008821. 31. Gordon LA, Morrison EY, McGrowder DA, et al. Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes. BMC Complement Altern Med 2008;8:21.
32.
Greendale GAHuang MHKarlamangla AS et al. Yoga decreases kyphosis in senior women and men with adult-onset hyperkyphosis: Results of a randomized controlled trialJ Am Geriatr Soc2009571569-1579. 32. Greendale GA, Huang MH, Karlamangla AS, et al. Yoga decreases kyphosis in senior women and men with adult-onset hyperkyphosis: Results of a randomized controlled trial. J Am Geriatr Soc 2009;57:1569–1579.
33.
Krishnamurthy MNTelles S. Assessing depression following two ancient Indian interventions: Effects of yoga and ayurveda on older adults in a residential homeJ Gerontol Nurs20073317-23. 33. Krishnamurthy MN, Telles S. Assessing depression following two ancient Indian interventions: Effects of yoga and ayurveda on older adults in a residential home. J Gerontol Nurs 2007;33:17–23.
34.
Manjunath NKTelles S. Pulmonary functions following yoga in a community dwelling geriatric population in IndiaJ Indian Psychol20062444-51. 34. Manjunath NK, Telles S. Pulmonary functions following yoga in a community dwelling geriatric population in India. J Indian Psychol 2006;24:44–51.
35.
Skoro-Kondza LTai SSGadelrab R et al. Community based yoga classes for type 2 diabetes: An exploratory randomised controlled trialBMC Health Serv Res2009933-33. 35. Skoro-Kondza L, Tai SS, Gadelrab R, et al. Community based yoga classes for type 2 diabetes: An exploratory randomised controlled trial. BMC Health Serv Res 2009;9:33–33.
36.
Stachenfeld NSMack GWDiPietro L et al. Regulation of blood volume during training in post-menopausal womenMed Sci Sports Exerc19983092-98. 36. Stachenfeld NS, Mack GW, DiPietro L, et al. Regulation of blood volume during training in post-menopausal women. Med Sci Sports Exerc 1998;30:92–98.
37.
Telles SNaveen VKBalkrishna A et al. Short term health impact of a yoga and diet change program on obesityMed Sci Monit201016CR35-CR40. 37. Telles S, Naveen VK, Balkrishna A, et al. Short term health impact of a yoga and diet change program on obesity. Med Sci Monit 2010;16:CR35–CR40.
38.
Williams KAPetronis JSmith D et al. Effect of Iyengar yoga therapy for chronic low back painPain2005115107-117. 38. Williams KA, Petronis J, Smith D, et al. Effect of Iyengar yoga therapy for chronic low back pain. Pain 2005;115:107–117.
39.
Rao MRRaghuram NNagendra HR et al. Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: A randomized controlled trialComplement Ther Med2009171-8. 39. Rao MR, Raghuram N, Nagendra HR, et al. Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: A randomized controlled trial. Complement Ther Med 2009;17:1–8.
40.
Kirkwood GRampes HTuffrey V et al. Yoga for anxiety: A systematic review of the research evidenceBr J Sports Med200539884-891;discussion 891. 40. Kirkwood G, Rampes H, Tuffrey V, et al. Yoga for anxiety: A systematic review of the research evidence. Br J Sports Med 2005;39:884–891;discussion 891.
41.
Morone NEGreco CM. Mind–body interventions for chronic pain in older adults: A structured reviewPain Med20078359-375. 41. Morone NE, Greco CM. Mind–body interventions for chronic pain in older adults: A structured review. Pain Med 2007;8:359–375.
42.
Galantino MLGalbavy RQuinn L. Therapeutic effects of yoga for children: A systematic review of the literaturePediatr Phys Ther20082066-80. 42. Galantino ML, Galbavy R, Quinn L. Therapeutic effects of yoga for children: A systematic review of the literature. Pediatr Phys Ther 2008;20:66–80.
43.
Chen KMTseng WS. Pilot-testing the effects of a newly developed silver yoga exercise program for female seniorsJ Nurs Res20081637-46. 43. Chen KM, Tseng WS. Pilot-testing the effects of a newly developed silver yoga exercise program for female seniors. J Nurs Res 2008;16:37–46.
44.
Chalmers TCSmith H JrBlackburn B et al. A method for assessing the quality of a randomized control trialControl Clin Trials1981231-49. 44. Chalmers TC, Smith H,Jr, Blackburn B, et al. A method for assessing the quality of a randomized control trial. Control Clin Trials 1981;2:31–49.
45.
Higgins JPTGreen SCochrane handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]The Cochrane collaboration2011www.cochrane–handbook.org 45. Higgins JPT, Green S (editors) Cochrane handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane collaboration, 2011. Available from www.cochrane–handbook.org
46.
Ades PASavage PDBrochu M et al. Resistance training increases total daily energy expenditure in disabled older women with coronary heart diseaseJ Appl Physiol2005981280-1285. 46. Ades PA, Savage PD, Brochu M, et al. Resistance training increases total daily energy expenditure in disabled older women with coronary heart disease. J Appl Physiol 2005;98:1280–1285.
47.
Ades PASavage PDCress ME et al. Resistance training on physical performance in disabled older female cardiac patientsMed Sci Sports Exerc2003351265-1270. 47. Ades PA, Savage PD, Cress ME, et al. Resistance training on physical performance in disabled older female cardiac patients. Med Sci Sports Exerc 2003;35:1265–1270.
48.
Blumenthal JAEmery CFMadden DJ et al. Effects of exercise training on bone density in older men and womenJ Am Geriatr Soc1991391065-1070. 48. Blumenthal JA, Emery CF, Madden DJ, et al. Effects of exercise training on bone density in older men and women. J Am Geriatr Soc 1991;39:1065–1070.
49.
Flegal KEKishiyama SZajdel D et al. Adherence to yoga and exercise interventions in a 6-month clinical trialBMC Complement Altern Med2007737. 49. Flegal KE, Kishiyama S, Zajdel D, et al. Adherence to yoga and exercise interventions in a 6-month clinical trial. BMC Complement Altern Med 2007;7:37.
50.
Madden DJBlumenthal JAAllen PA et al. Improving aerobic capacity in healthy older adults does not necessarily lead to improved cognitive performancePsychol Aging19894307-320. 50. Madden DJ, Blumenthal JA, Allen PA, et al. Improving aerobic capacity in healthy older adults does not necessarily lead to improved cognitive performance. Psychol Aging 1989;4:307–320.
51.
Cooper CBalamurali TBSelwood A et al. A systematic review of intervention studies about anxiety in caregivers of people with dementiaInt J Geriatr Psychiatry200722181-188. 51. Cooper C, Balamurali TB, Selwood A, et al. A systematic review of intervention studies about anxiety in caregivers of people with dementia. Int J Geriatr Psychiatry 2007;22:181–188.
52.
Studenski SPerera SPatel K et al. Gait speed and survival in older adultsJAMA201130550-58. 52. Studenski S, Perera S, Patel K, et al. Gait speed and survival in older adults. JAMA 2011;305:50–58.
53.
Studenski SPerera SWallace D et al. Physical performance measures in the clinical settingJ Am Geriatr Soc200351314-322. 53. Studenski S, Perera S, Wallace D, et al. Physical performance measures in the clinical setting. J Am Geriatr Soc 2003;51:314–322.
54.
Patel NAkkihebbalu SEspinoza SEChiodo LK. Perceptions of community based yoga intervention for older adultsActivities, Adaptation Aging201135151-163. 54. Patel N, Akkihebbalu S, Espinoza, SE, Chiodo, LK. Perceptions of community based yoga intervention for older adults. Activities, Adaptation Aging 2011;35:151–163.
Information & Authors
Information
Published In
The Journal of Alternative and Complementary Medicine
Volume 18 • Issue Number 10 • October 2012
Pages: 902 - 917
PubMed: 22909385
Copyright
Copyright 2012, Mary Ann Liebert, Inc.
History
Published online: 11 October 2012
Published in print: October 2012
Published ahead of print: 21 August 2012
Topics
Authors
Disclosure Statement
No conflicts of interest exist.
Metrics & Citations
Metrics
Citations
Export Citation
Export citation
Select the format you want to export the citations of this publication.
View Options
Get Access
Access content
To read the fulltext, please use one of the options below to sign in or purchase access.⚠ Society Access
If you are a member of a society that has access to this content please log in via your society website and then return to this publication.