Yoga Therapy for Alzheimers

 Yoga Therapy for Alzheimers

Scientific Article Review Studying Yoga Therapy for Alzheimer’s

1. Yoga training's effects on inflammatory markers and cognitive function in women at high risk for Alzheimer's Disease. This study investigated the inflammatory marker response to memory enhancement training (MET) compared to combined Kundalini yoga (KY) and Kirtan Kriya (KK), as well as determine the predictive value of inflammatory markers on cognitive function, through a randomized study targeting women with high risk for Alzheimer's Disease.

Methods- Women with current subjective memory complaints and high cardiovascular risk were randomized to either a 12-week trial of the behavioral intervention MET or Yoga. Participants were assessed with a comprehensive cognitive battery and a panel of cytokines at baseline, 12 weeks, and 24 weeks. The following cognitive domain scores were calculated: learning, delayed recall, language, executive function, and processing speed. Regression models were used to examine whether cytokine (proteins that help control inflammation in your body) levels at baseline were predictive of changes in cognitive domain scores.

Results- Of the 76 randomized participants (Yoga: n= 38 and MET: n= 38), 18 Yoga and 27 MET completed the 12-week assessment, and 26 Yoga and 32 MET completed the 24-week assessment. The groups did not differ at baseline in any measure. At follow-up, there was a significant increase in Eotaxin in the Yoga group and significant increases in FGF2 in both groups. From regression modeling, higher IFNg, IL_8, IL10, and IL12_p40 levels at baseline were predictive of improvement in processing speed in the MET group, but not the Yoga group, at 24 weeks. Higher sCD40L levels at baseline were predictive of improvement in learning in Yoga group but not in MET group.

Conclusions- We observed significant changes in individual cytokine levels at the end of the intervention. Initial predictive analysis shows correlations between baseline cytokine levels and changes in cognitive function outcome measures. This may have implications for evaluating the impact of alternative interventions on cognitive function and Alzheimer's disease progression.

2. Effects of Meditation versus Music Listening on Perceived Stress, Mood, Sleep, and Quality of Life in Adults with Early Memory Loss: A Pilot Randomized Controlled Trial

Methods- In this randomized controlled trial, we assessed the effects of two 12-week relaxation programs, Kirtan Kriya Meditation (KK) and music listening (ML), on perceived stress, sleep, mood, and health-related QOL in older adults with SCD. Sixty community-dwelling older adults with SCD were randomized to a KK or ML program and asked to practice 12 minutes daily for 12 weeks, then at their discretion for the following 3 months. At baseline, 12 weeks, and 26 weeks, perceived stress, mood, psychological well-being, sleep quality, and health-related QOL were measured using well-validated instruments.

Results- Fifty-three participants (88%) completed the 6-month study. Participants in both groups showed significant improvement at 12 weeks in psychological well-being and in multiple domains of mood and sleep quality. Relative to ML, those assigned to KK showed greater gains in perceived stress, mood, psychological well-being, and QOL-Mental Health. Observed gains were sustained or improved at 6 months, with both groups showing marked and significant improvement in all outcomes. Changes were unrelated to treatment expectancies.

Conclusions- Findings suggest that practice of a simple meditation or ML program may improve stress, mood, well-being, sleep, and QOL in adults with SCD, with benefits sustained at 6 months and gains that were particularly pronounced in the KK group.

3. The Effects of Yoga on Patients with Mild Cognitive Impairment and Dementia: A Scoping Review

Methods- Eight studies were identified that reported on yoga as either the primary intervention or one component of a multi-component intervention in samples of persons with MCI or dementia.

Results- Results suggest that yoga may have beneficial effects on cognitive functioning, particularly on attention and verbal memory. Further, yoga may affect cognitive functioning through improved sleep, mood, and neural connectivity. Studies found significant differences between the yoga and control groups at post-intervention on measures of neuropsychiatric symptoms, cardiopulmonary functioning, flexibility, muscle strength and endurance, and balance.

Conclusions-  There are a number of limitations of the existing studies, including a lack of intervention details, as well as variability in the frequency/duration and components of the yoga interventions. A further complicating issue is the role of various underlying etiologies of cognitive impairment. Despite these limitations, providers may consider recommending yoga to persons with MCI or dementia as a safe and potentially beneficial complementary health approach.

4. Determining the mechanism behind yoga’s effects on preventing the symptoms of Alzheimer’s disease

Methods- In 2014 a novel therapeutic program for treatment of AD, known as metabolic enhancement for neurodegeneration, incorporated yoga and meditation into a regimen targeting multiple aspects of early AD pathology, achieving sustained cognitive improvement in 9 out 10 patients, including unprecedented quantitative and qualitative improvements after 24 months.

Results- We hypothesized that the neurotransmitters secreted during the practices of meditation and yoga could potentially reverse the effects of AD using a previously described in vitro model of AD. These studies provide evidence that yoga or meditative practice contribute to slowing the progression of cognitive decline in AD.

Conclusions- By identifying key movements, like ones supported by Kirtan Kriya (singing a specific mantra along with sequential tapping of the fingertips), yoga therapies could be more precisely prescribed to Alzheimer patients, fully realizing the therapeutic potential of yoga and meditative practices in treating AD.

5. Ayurveda and Yoga practices: a synergistic approach for the treatment of Alzheimer’s disease

Methods- This review is mainly focused on to adapt Ayurveda and Yoga approaches for the treatment of Alzheimer’s disease. Buchanania axillaris Desr. (Anacardiaceae),  Hemidesmus indicus  Linn.  (Apocynaceae)  and  Rhus  mysorensis  Heyne  (Anacardiaceae) were identified as multifunctional therapeutics for the treatment of AD. Several studies have been shown that ayurvedic medicines play a vital role to treat the AD such as Gingko biloba for slow progression of AD, Galanthus caucasicus for treating memory impairments, Huperzia serrata for improving memory and mental functioning in AD patients, Catharanthus roseus for treating memory loss and mental impairments, Melissa officinalis for improving cognitive function and reducing the agitation, Curcuma longa (curcumin) increases phagocytosis of amyloid-beta  that effectively clearing  them from the brains of patients with AD and Withania somnifera (Ashwagandha) for stopping  reverse and removing the neuritic atrophy and synaptic loss that is the main cause of neurodegeneration. In recent years, some studies have been reported that AD disease could be treated by biomolecules extracted by plants such as kaempferol, is flavonoid, have been found to reduce the neurotoxic motor and cognitive impairments in AD flies and oleanolic acid extracted from a Chinese herb, is pentacyclic triterpene, found to enhance Aβ  induced memory loss and to  restore synaptic plasticity in AD rats. Various isolated compounds (alkaloids) have extracted from Esenbeckia leiocarpa (Rutaceae), Coptidis rhizoma and Corydalis cava  (Fumariaceae) plants that were reported for acetylcholinesterase and butyrylcholinesterase inhibitory activity.

Results- Ayurveda and Yoga are significantly contributed in several distinctive treatment modalities for the Alzheimer’s treatment. The researchers have found that these features are essential to modulate neuro-immune activities, enhance memory, intellect, rejuvenate brain functions, allay neurodegenerative cascades of AD and improve quality life.

Yoga is a non-religious mind-body approach of ancient India that integrates the spiritual, mental and physical components to improve health and well-being. Yoga has several essential benefits and is positively impactful for various body systems such as the musculoskeletal system, cardiopulmonary, nervous and endocrine systems. Meditation has great potential in stress reducing effects that is beneficial for preventing cognitive and memory loss. Stress is dependent upon the level of cortisol in the body that is responsible for progression of Alzheimer's disease, which can be regulated by a regular practice of meditation. 

Conclusions- Ayurvedic therapeutic approaches and Yoga practices have been widely used for the health promotion, disease prevention and possible treatment of Alzheimer's  disease. Yoga is vital for treating neurodegenerative disorders by combining several combined yogic exercises. The combination of Ayurveda and Yoga would provide a significant outcome for the noble strategy of the treatment of Alzheimer’s disease. These combinations might be proved to provide the better panacea for AD in future. 

6. Effects of Hatha-Yoga Program on a Small Group with Alzheimer’s Disease

Methods- Eight volunteer patients diagnosed with AD (moderate dementia). There were seven women and a man over 60 years old. These instruments were used to measure each dependent variable: 1. Quality of life in patients diagnosed with Alzheimer Disease (ADRQL). It is a hetero - applied scale where the caregiver gives answers based on the patient behavior during the last two weeks previous the program. 2. Hamilton scales for measuring anxiety and depression. These scales test the symptomatic profile as well as the seriousness of the anxious and depressive manifestation during last days. These instruments are hetero - applied. 3. Working memory and processing speed indexes. The respective sub-tests -appropriate for the aged they were diagnosed with dementia - of the intelligence scale WAIS III of Wechsler were applied. 4. Tinetti Scale. This scale assesses walking and equilibrium. A score of less than 10 in equilibrium items or less than 9 in walking items represents high risk of falling. 5. Sit and Reach modified test. It measures flexibility in centimeters. 6. Barthel Scale. It was published by Mahoney and Barthel in 1965. It is useful for testing daily life activities in patients who suffer neuro-muscular and muscle-skeletal disorders. 7. Lawton and Brody Scale. It is also known as Philadelphia Geriatric Center Instrumental Activities Daily Living. It is recommended for testing instrumental activities carried out by non institutionalized people. This Scale shows the capacity of functional autonomy. 8. Qualitative questionnaire. Used for the identification of the caregivers’ perception about the program, the adherence

Results- The research has shown that the underlying neuroanatomical system responsible for procedural memory is independent of declarative memory; and, therefore, patients with Alzheimer’s can acquire motor, perceptual and cognitive skills.

Conclusions- our results in people with dementia showed beneficial effects of yoga on physical performance, these findings revealed a possible impact on functional abilities, self-esteem and level of independence in everyday life. Using ancient techniques like yoga, which has shown benefits in different populations by the combination of the triad: relaxation-breathing-relaxation, in a physical (postures) and cognitive (attention-concentration constant) context, it represents an option that worth studying, and to be validated with more consistent and ecological measuring instruments. All of this, directed to provide non-pharmacological programs that can provide alternative interventions. 

7. Potential benefits of mindfulness-based interventions in mild cognitive impairment and Alzheimer's disease: An interdisciplinary perspective

Methods- Typically taught in the context of an 8-week program, MBI include a variety of formal meditative exercises: body scan, gentle yoga, sitting meditation, and walking meditation. These are introduced in a small group setting, and practiced at home several days a week with the help of CDs and written instructions. Also, mindful attitudes (e.g., acceptance, patience, beginner's mind) are discussed during the program.

Results- Opposed to adverse factors responsible for neurodegeneration is the possibility of building “brain reserve”, which refers to maximal brain volume and neuronal complexity as a protection against dementia and brain damage. Its behavioral equivalent, named “cognitive reserve”, refers to cognitive capacities that are protective against functional impairment. McEwen recommended reversal of allostatic load using brain-centered interventions to promote health, such as pharmacological agents, exercise, and social support. In the same vein, Lange-Asschenfeldt and Kojda found evidence that physical exercise builds reserve and prevents neural degeneration.

Conclusions- It will be argued that in addition to being minimally invasive and very cost-effective, MBI could help modify several risk factors of AD and this, in turn, could prevent or delay the neuropathological cascade leading to cerebral and cognitive decline. 

8. The Pink Brain Project: How Yoga Meditation may Prevent Alzheimer’s in Women

Methods- 161 women out of 214 subjects (75%) across six RCT's with SCD, MCI or stressed family caregivers were studied utilizing Kirtan Kriya (KK), an easy 12 minute/day yoga meditation. The control group consisted of either music listening or memory enhancement training (MET). Memory, cognitive function and various biomarkers were measured at baseline, 3 and 6 months.

Results- Practicing KK 12 minutes a day for 8 - 12 weeks improves cognitive function, increases cerebral blood flow, augments neurotransmitters and neuroanatomical plasticity in the anterior and posterior cingulate gyrus, hippocampus, & pre- frontal cortex. Moreover, these studies show improved mental health, better sleep, reduced stress, increased telomerase and longer telomeres, reduced inflammatory markers, strengthened neuro-connectivity, increased plasma amyloid beta, and a rise in aspects of psycho-spiritual well-being such as self- acceptance and a sense of purpose in life. All of these benefits may help prevent or reverse cognitive decline. Gains were sustained or improved at 6 months. No side effects were reported.

Conclusions- Kirtan Kriya is a simple and effective yoga meditation with striking results, including an improvement in cognitive function in SCD and MCI. KK has significant potential to be valuable in the fight against AD in women.

9. Yoga Prevents Gray Matter Atrophy in Women at Risk for Alzheimer's Disease: A Randomized Controlled Trial

Methods- In this study, we investigated brain gray matter volume (GMV) changes in older women with SCD and CVRFs following three months of yoga compared to memory enhancement training (MET). Eleven women (mean age = 61.45, SD = 6.58) with CVRF and SCD completed twelve weeks of Kundalini Yoga and Kirtan Kriya (KY + KK) while eleven women (mean age = 64.55, SD = 6.41) underwent MET. Anxiety, resilience, stress, and depression were assessed at baseline and 12 weeks, as were T1-weighted MRI scans (Siemens 3T Prisma scanner). We used Freesurfer 6.0 and tested group differences in GMV change, applying Monte-Carlo simulations with alpha = 0.05. Region-of-interest analysis was performed for hippocampus and amygdala.

Results-Compared to KY + KK, MET showed reductions in GMV in left prefrontal, pre- and post-central, supramarginal, superior temporal and pericalcarine cortices, right paracentral, postcentral, superior and inferior parietal cortices, the banks of the superior temporal sulcus, and the pars opercularis.

Conclusions-  Yoga training may offer neuroprotective effects compared to MET in preventing neurodegenerative changes and cognitive decline, even over short time intervals. Future analyses will address changes in functional connectivity in both groups.

Summary of Conclusions: Based on a review and synopsis of all the literature Yoga Therapies have been shown to improve neuroprotective effects compared to MET in preventing neurodegenerative changes in Subjective Cognitive Decline and Mild cognitive Impairment. The impact on functional abilities, self-esteem and level of independence in everyday life. Yoga therapies help modulate neuro-immune activities, enhance memory, intellect, rejuvenate brain functions, and improve quality life. Studies show neurotransmitters secreted during the practices of meditation and yoga could potentially reverse the effects of AD using a previously described in vitro model of AD. Results suggest that yoga may have beneficial effects on cognitive functioning, particularly on attention and verbal memory. Further, yoga may affect cognitive functioning through improved sleep, mood, and neural connectivity, neuropsychiatric symptoms, cardiopulmonary functioning, flexibility, muscle strength, endurance, and balance. Findings suggest that practice of a simple Meditation program may improve stress, mood, well-being, sleep, and QOL in adults with SCD. Studies suggest there was a significant increase in Eotaxin, a small protein that is produced in the lungs of asthmatic patients and is a potent chemoattractant for eosinophils. Shown benefits in the combination of the triad: relaxation-breathing-relaxation, in a physical (postures) and cognitive (attention-concentration constant). Yoga Therapies are minimally invasive and very cost-effective. Ayurvedic Medicines may also support AD treatment as anti-oxident, anti-amyloidogenic, anti-inflammatory and neuroprotective. 

Reference List:

1. Author links open overlay panelMeghan Reddy BA 1, 1, 2, and IntroductionUnderlying inflammation is associated with an increased risk of depression in older adults. We aimed to investigate the inflammatory marker response to memory enhancement training (MET) compared to combined Kundalini yoga (KY) and Kirtan Kriya. “Yoga Training’s Effects on Inflammatory Markers and Cognitive Function in Women at High Risk for Alzheimer’s Disease.” The American Journal of Geriatric Psychiatry, February 16, 2023. https://www.sciencedirect.com/science/article/abs/pii/S1064748122007436. 

2. Innes KE, Selfe TK, Khalsa DS, Kandati S. Effects of Meditation versus Music Listening on Perceived Stress, Mood, Sleep, and Quality of Life in Adults with Early Memory Loss: A Pilot Randomized Controlled Trial. J Alzheimers Dis. 2016 Apr 8;52(4):1277-98. doi: 10.3233/JAD-151106. PMID: 27079708; PMCID: PMC5649740.

3. Author links open overlay panelGretchen A. Brenes Ph.D. a, a, b, c, d, e, f, et al. “The Effects of Yoga on Patients with Mild Cognitive Impairment and Dementia: A Scoping Review.” The American Journal of Geriatric Psychiatry, October 25, 2018. https://www.sciencedirect.com/science/article/abs/pii/S1064748118305347. 

4. Hassan, Adithy, Meghan Robinson, and Stephanie M Willerth. “Determining the Mechanism behind Yoga’s Effects on Preventing the Symptoms of Alzheimer’s Disease.” Neural regeneration research, February 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6905332/. 

5. Mishra, S. K. (2021b). Ayurveda and Yoga practices: a synergistic approach for the treatment of Alzheimer’s disease. https://www.journals.tmkarpinski.com/index.php/ejbr/article/view/337

6. Alexey, Eliana, Guzman Lina, Alexander Reyes and Olga Lucía Llanos. “Effects of Hatha-Yoga Program on a Small Group with Alzheimer's.” (2011).

7. Larouche E, Hudon C, Goulet S. Potential benefits of mindfulness-based interventions in mild cognitive impairment and Alzheimer's disease: an interdisciplinary perspective. Behav Brain Res. 2015 Jan 1;276:199-212. doi: 10.1016/j.bbr.2014.05.058. Epub 2014 Jun 2. PMID: 24893317.

8. Khalsa, dharma singh- Khalsa, Tejinder- 2018/07/01- P1371- P1372 THE PINK BRAIN PROJECT: HOW YOGA MEDITATION MAY PREVENT ALZHEIMER’S IN WOMEN - 1410.1016/j.jalz.2018.06.1992 Alzheimer's & Dementia

9. Krause-Sorio B, Siddarth P, Kilpatrick L, Milillo MM, Aguilar-Faustino Y, Ercoli L, Narr KL, Khalsa DS, Lavretsky H. Yoga Prevents Gray Matter Atrophy in Women at Risk for Alzheimer's Disease: A Randomized Controlled Trial. J Alzheimers Dis. 2022;87(2):569-581. doi: 10.3233/JAD-215563. PMID: 35275541; PMCID: PMC9198760.