Changes in Neural Connectivity and Memory Following a Yoga Intervention for Older Adults: A Pilot Study

The Impact of Kundalini Yoga on Cognitive Function and Memory: A Systematic Review of Randomized Controlled Trials

Cognitive decline and dementia are significant public health challenges influenced by various modifiable and non-modifiable risk factors. Kundalini yoga (KY) has emerged as a promising non-pharmacological intervention to enhance cognitive function and memory in older adults at risk of cognitive decline. This systematic review aims to evaluate the effects of KY on cognitive function, memory impairment, and related neurobiological and psychological outcomes in older adults. A comprehensive literature search was conducted across PubMed, MEDLINE, Scopus, Web of Science, and the Cochrane Library, covering studies published from January 2000 to December 2023. Randomised controlled trials (RCTs) were included to compare KY with other cognitive enhancement strategies, such as memory enhancement training (MET) and psychoeducation. Five RCTs with 215 participants met the inclusion criteria. The studies varied in sample size (11 to 81 participants) and duration (12 to 24 weeks). The participants were older adults (≥55 years) with mild cognitive impairment (MCI) or subjective cognitive decline (SCD). The interventions compared KY with MET or psychoeducation. KY consistently improved memory performance and executive function. Significant mood enhancements, increased hippocampal volume, and better neural connectivity were observed. KY also reduced pro-inflammatory cytokines and altered ageing-related gene expression, demonstrating both cognitive and neurobiological benefits. KY appears to be a promising intervention for enhancing cognitive function, mood, and neurobiological health in older adults at risk of cognitive decline and dementia. While further research with more extensive, well-designed RCTs is needed to confirm these findings and optimise intervention strategies, the existing evidence supports the integration of KY into cognitive health programmes. Practitioners should ensure proper training and gradual progression to maximise benefits and minimise risks.

Effects of mind-body exercise on knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

To evaluate the effect of mind-body exercise on improving knee osteoarthritis (KOA) and thereby informing osteoarthritis exercise rehabilitation.

METHODS

The China National Knowledge Infrastructure (CNKI), Wanfang, PubMed/Medline, Cochrane Library, Web of Science, EBSCO, Embase, Scopus, and ProQuest databases were searched to identify randomized controlled trials (RCTs) that involved tai chi, yoga, and baduanjin interventions for KOA. The search period ranged from inception to October 25, 2022. The methodological quality of the included studies was evaluated by the Cochrane risk of bias assessment tool, and the included data were statistically analyzed and plotted using Review Manager 5.3 and Stata 14.0 software.

RESULTS

We included 17 articles with a total of 1122 patients. Compared with the control group, mind-body exercise significantly improved patient pain (standardized mean difference (SMD) = -0.65, 95% confidence interval (CI) [-0.87, -0.42], p < 0.00001), stiffness (SMD = -0.75, 95% CI [-1.05, -0.45], p < 0.00001), physical function (SMD = -0.82, 95% CI [-1.03, -0.62], p < 0.00001), mental health (SMD = 0.31, 95% CI [0.11, 0.51], p = 0.002), and depression (SMD = -0.32, 95% CI [-0.50, -0.15], p = 0.0003). In terms of motor ability, mind-body exercise significantly increased the 6-min walking distance (SMD = 18.45, 95% CI [5.80, 31.10], p = 0.004) and decreased timed up and go test time (SMD = -1.15, 95% CI [-1.71, -0.59], p < 0.0001).

CONCLUSIONS

The current study showed that mind-body exercise is safe and effective for KOA patients. However, given the methodological limitations of the included studies, additional high-quality evidence is needed to support the conclusions of this study.

Cognitive and immunological effects of yoga compared to memory training in older women at risk for alzheimer's disease

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) accompanied by cerebrovascular risk factors (CVRFs) are known to increase the risk of developing dementia. Mind-body practices such as yoga and meditation, have been recognized as safe techniques with beneficial effects on cognitive functions in older adults at risk for cognitive decline. We conducted a randomized, controlled trial to assess the efficacy of Kundalini yoga training (KY) compared to memory enhancement training (MET) on mood and cognitive functioning in a group of older women with CVRFs and SCD (clinicaltrials.gov = NCT03503669). The KY intervention consisted of weekly, 60-min in-person classes with a certified instructor for 12 weeks, with a 12-min guided recording for daily homework practice at home. MET involved 12 weekly in-person group classes with 12-min daily homework exercises. Objective and subjective memory performance were the primary outcomes. Peripheral whole blood samples were collected at baseline, 12-weeks, and 24-weeks follow-up for RNA sequencing and cytokine/chemokine assays. A total of 79 patients (KY = 40; MET = 39) were randomized, and 63 completed the 24-week follow-up (KY = 65% completion rate; MET = 95%; χ2(1) = 10.9, p < 0.001). At 24-weeks follow-up, KY yielded a significant, large effect size improvement in subjective cognitive impairment measures compared to MET. KYOn a transcriptional level, at 12- and 24-week follow-up, KY uniquely altered aging-associated signatures, including interferon gamma and other psycho-neuro-immune pathways. Levels of chemokine eotaxin-1, an aging marker, increased over time in MET but not KY participants. These results suggest clinical and biological benefits to KY for SCD, linking changes in cognition to the anti-inflammatory effects of yoga.

The effects of mind-body exercise on anxiety and depression in older adults: a systematic review and network meta-analysis

Background

Limited research directly compares the clinical effects of different types of mind-body exercises on anxiety and depression in older adults. Therefore, we conducted a systematic review and network meta-analysis of randomized controlled trials that meet the inclusion criteria to explore the intervention effects of five different types of mind-body exercises in improving anxiety and depression in older adults.

Methods

We followed the PRISMA-NMA guidelines and conducted searches in the Web of Science, PubMed, the Cochrane Library, and Embase databases up to July 28, 2023. The language was limited to English. Two independent reviewers conducted literature screening and data extraction. Review Manager 5.4 was used to perform Pairwise meta-analysis and risk assessment, while STATA version 15 software was used for network meta-analysis.

Result

A total of 42 studies, involving 2974 participants, were included. The results of the traditional meta-analysis showed that mind-body exercises were superior to the control group in alleviating anxiety (SMD: -0.87, 95% CI: -1.43, -0.31, p<0.05, I2 = 95%) and depressive (SMD: -0.52, 95% CI: -0.71, -0.34, p<0.05, I2 = 80%). In the network meta-analysis, the ranking of treatment effects for anxiety showed that Tai Chi > Qigong > Yoga > Dance > control group, while for depression, the ranking showed Tai Chi > Pilates > Yoga > Qigong > Dance > control group.

Conclusion

This study found that mind-body exercises have positive effects on improving anxiety and depression in older adults. Among the five different types of mind-body exercise interventions, Tai Chi was considered an effective approach for improving anxiety and depression. However, we encourage older adults to choose exercise modalities that suit their interests to enhance adherence.

Systematic review registration

http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023464296.

Longitudinal changes in resting state fMRI brain self-similarity of asymptomatic high school American football athletes

American football has become the focus of numerous studies highlighting a growing concern that cumulative exposure to repetitive, sports-related head acceleration events (HAEs) may have negative consequences for brain health, even in the absence of a diagnosed concussion. In this longitudinal study, brain functional connectivity was analyzed in a cohort of high school American football athletes over a single play season and compared against participants in non-collision high school sports. Football athletes underwent four resting-state functional magnetic resonance imaging sessions: once before (pre-season), twice during (in-season), and once 34-80 days after the contact activities play season ended (post-season). For each imaging session, functional connectomes (FCs) were computed for each athlete and compared across sessions using a metric reflecting the (self) similarity between two FCs. HAEs were monitored during all practices and games throughout the season using head-mounted sensors. Relative to the pre-season scan session, football athletes exhibited decreased FC self-similarity at the later in-season session, with apparent recovery of self-similarity by the time of the post-season session. In addition, both within and post-season self-similarity was correlated with cumulative exposure to head acceleration events. These results suggest that repetitive exposure to HAEs produces alterations in functional brain connectivity and highlight the necessity of collision-free recovery periods for football athletes.

Protective roles of meditation practice and self-esteem on cognitive functions over time: findings from the Midlife in the United States study

BACKGROUND

Cognitive function is an important component of healthy ageing. However, it is unclear whether relaxation/meditation practices provide cognitive benefits, particularly in midlife and early late life. Meditative practices are associated with higher self-esteem, and self-esteem serves as a general protective factor for many health outcomes. The current study examines associations between meditation practice, self-esteem, and change over 10 years in midlife cognitive performance.

METHODS

Data were from waves 2 (2003-2004) and 3 (2013-2014) of the Midlife in the United States (MIDUS) study. We used structural equation modelling to examine whether persistent meditation practice at both waves or episodic practice at one wave is associated with better cognitive function over 10 years, compared to no meditation practice, while controlling for prior cognitive function and covariates (baseline socio-demographics, health, and functional status). Additionally, we assessed if self-esteem mediates the above associations.

RESULTS

We included 2168 individuals (Mage  = 65 ± 11). After controlling for covariates, the findings revealed that persistent meditation practice in both waves was associated with significantly less decline in episodic memory; however, no such effects were found for executive function. Further, although participants' higher self-esteem was significantly associated with less decline in executive function and episodic memory, it did not mediate the associations between meditation practice and cognitive functions.

CONCLUSIONS

While both persistent meditation practice and self-esteem have associations with cognitive outcomes for middle-aged and older adults in MIDUS, self-esteem as a mediator was not supported. Thus, future investigations should examine mechanisms that underlie these protective factors on cognitive performances across adulthood.

Online Chair Yoga and Digital Learning for Rural Underserved Older Adults at Risk for Alzheimer's Disease and Related Dementias

OBJECTIVES

We evaluated the feasibility and preliminary efficacy of a home-based online chair yoga (OCY) program for racially and ethnically diverse rural community-dwelling older adults.

METHODS

We randomly assigned participants to OCY or a computer brain game (CBG). After a computer literacy training led by high school students, participants engaged in remotely supervised OCY or CBG in twice-weekly 45-minute sessions for 12 weeks. Outcome data (pain interference, cognitive function, mobility, computer skills) were collected at baseline, post-intervention, and 3-month follow-up.

RESULTS

A total of 32 eligible residents with mean age of 71 years participated in this intervention study. The interventions were feasible (100% recruitment rate, 96.8% retention rate, 100% safety rate). There were significant improvements in pain interference, cognitive function, mobility, and computer skills from baseline to follow-up among participants in both OCY and CBG but no significant differences in outcomes between groups.

CONCLUSIONS

Preliminary results indicated that the CBG was as effective as online OCY in clinical outcomes in these participants. However, this should be confirmed in future studies.

CLINICAL IMPLICATIONS

This telehealth-based intervention is feasible for older adults in rural and digitally underserved communities and could provide a strategy for delivering health-promoting interventions for home-bound older adults at risk for Alzheimer's disease and related dementias (ADRD) and connect caregivers to online resources.

Comparative efficacy of various exercise interventions on depression in older adults with mild cognitive impairment: A systematic review and network meta-analysis

BACKGROUND

Exercise is a promising nonpharmacological treatment for improving depression in older adults with MCI, but it is unclear which exercises are most effective. The objectives of this study were to compare and rank the effectiveness of various exercise interventions for depression in mild cognitive impairment (MCI) and to investigate the effects of exercise on depression.

METHODS

The PRISMA-NMA guidelines were applied to the development and reporting of review criteria. The Cochrane Library, Web of Science, PsycINFO, PubMed, EMBASE, CINAHL, and Scopus databases were systematically searched by combining search terms for randomized controlled trial studies (RCTs) published in English from individual databases with the earliest available date set to March 10, 2023. Two evaluators independently selected and evaluated eligible studies of changes in depression in older adults with MCI after an exercise intervention. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42022377052).

RESULTS

A network meta-analysis was conducted on 15 eligible RCTs consisting of 4271 subjects, including aerobic (n = 6), mind-body (n = 6) and multicomponent (n = 3) exercise trials. Compared to controls, mind-body exercise showed the strongest improvement in depressive symptoms (SMD = -0.63, 95% CI: -1.13, -0.14), followed by aerobic (SMD = -0.57, 95% CI: -0.88, -0.26) and multicomponent exercise (SMD = -0.53, 95% CI: -1.02, -0.03). Notably, there were no statistically significant differences between exercise types: aerobic vs. mind-body (SMD = 0.06, 95% PrI: -0.71, 0.84), multicomponent vs. mind-body (SMD = 0.11, 95% PrI: -0.75, 0.97), or multicomponent vs. aerobic (SMD = 0.04, 95% PrI: -0.771, 0.86).

CONCLUSIONS

In this review, we found that mind-body exercise was most effective when compared to conventional controls and that multiple exercise modalities (aerobic, mind-body, and multicomponent exercise) had beneficial and comparable effects in reducing depressive states in older adults with MCI. These findings may guide clinical geriatric stakeholders and allied health professionals in providing more scientifically optimal exercise prescriptions for older adults with MCI. In the future, more high-quality, long-term clinical trials are needed to support the exploration of longer-term dynamic effects.

Rehabilitation for non-motor symptoms for patients with Parkinson's disease from an α-synuclein perspective: a narrative review

Parkinson's disease (PD) is a common neurodegenerative disorder affecting aged population around the world. PD is characterized by neuronal Lewy bodies present in the substantia nigra of the midbrain and the loss of dopaminergic neurons with various motor and non-motor symptoms associated with the disease. The protein α-synuclein has been extensively studied for its contribution to PD pathology, as α-synuclein aggregates form the major component of Lewy bodies, a hallmark of PD. In this narrative review, the authors first focus on a brief explanation of α-synuclein aggregation and circumstances under which aggregation can occur, then present a hypothesis for PD pathogenesis in the peripheral nervous system (PNS) and how PD can spread to the central nervous system from the PNS via the transport of α-synuclein aggregates. This article presents arguments both for and against this hypothesis. It also presents various non-pharmacological rehabilitation approaches and management techniques for both motor and non-motor symptoms of PD and the related pathology. This review seeks to examine a possible hypothesis of PD pathogenesis and points to a new research direction focus on rehabilitation therapy for patients with PD. As various non-motor symptoms of PD appear to occur earlier than motor symptoms, more focus on the treatment of non-motor symptoms as well as a better understanding of the biochemical mechanisms behind those non-motor symptoms may lead to better long-term outcomes for patients with PD.

The neurobiological effects of mind-body exercise: a systematic review and meta-analysis of neuroimaging studies

The neurobiological effects of mind-body exercise on brain activation, functional neural connections and structural changes in the brain remain elusive. This systematic review and coordinate-based meta-analysis investigated the changes in resting-state and task-based brain activation, as well as structural brain changes before and after mind-body exercise compared to waitlist or active controls based on published structural or functional magnetic resonance imaging randomized controlled trials or cross-sectional studies. Electronic database search and manual search in relevant publications yielded 34 empirical studies with low-to-moderate risk of bias (assessed by Cochrane risk-of-bias tool for randomized trials or Joanna Briggs Institute's critical appraisal checklist for analytical cross-sectional studies) that fulfilled the inclusion criteria, with 26 studies included in the narrative synthesis and 8 studies included in the meta-analysis. Coordinate-based meta-analysis showed that, while mind-body exercise enhanced the activation of the left anterior cingulate cortex within the default mode network (DMN), it induced more deactivation in the left supramarginal gyrus within the ventral attention network (uncorrected ps < 0.05). Meta-regression with duration of mind-body practice as a factor showed that, the activation of right inferior parietal gyrus within the DMN showed a positive association with increasing years of practice (voxel-corrected p < 0.005). Although mind-body exercise is shown to selectively modulate brain functional networks supporting attentional control and self-awareness, the overall certainty of evidence is limited by small number of studies. Further investigations are needed to understand the effects of both short-term and long-term mind-body exercise on structural changes in the brain.PROSPERO registration number: CRD42021248984.

Move Your Body, Boost Your Brain: The Positive Impact of Physical Activity on Cognition across All Age Groups

While the physical improvements from exercise have been well documented over the years, the impact of physical activity on mental health has recently become an object of interest. Physical exercise improves cognition, particularly attention, memory, and executive functions. However, the mechanisms underlying these effects have yet to be fully understood. Consequently, we conducted a narrative literature review concerning the association between acute and chronic physical activity and cognition to provide an overview of exercise-induced benefits during the lifetime of a person. Most previous papers mainly reported exercise-related greater expression of neurotransmitter and neurotrophic factors. Recently, structural and functional magnetic resonance imaging techniques allowed for the detection of increased grey matter volumes for specific brain regions and substantial modifications in the default mode, frontoparietal, and dorsal attention networks following exercise. Here, we highlighted that physical activity induced significant changes in functional brain activation and cognitive performance in every age group and could counteract psychological disorders and neural decline. No particular age group gained better benefits from exercise, and a specific exercise type could generate better cognitive improvements for a selected target subject. Further research should develop appropriate intervention programs concerning age and comorbidity to achieve the most significant cognitive outcomes.

Combining exercise with cognitive training and vitamin D3 to improve functional brain connectivity (FBC) in older adults with mild cognitive impairment (MCI). Results from the SYNERGIC trial

Changes in functional brain connectivity (FBC) may indicate how lifestyle modifications can prevent the progression to dementia; FBC identifies areas that are spatially separate but temporally synchronized in their activation and is altered in those with mild cognitive impairment (MCI), a prodromal state between healthy cognitive aging and dementia. Participants with MCI were randomly assigned to one of five study arms. Three times per week for 20-weeks, participants performed 30-min of (control) cognitive training, followed by 60-min of (control) physical exercise. Additionally, a vitamin D₃ (10,000 IU/pill) or a placebo capsule was ingested three times per week for 20-weeks. Using the CONN toolbox, we measured FBC change (Post-Pre) across four statistical models that collapsed for and/or included some or all study arms. We conducted Pearson correlations between FBC change and changes in physical and cognitive functioning. Our sample included 120 participants (mean age: 73.89 ± 6.50). Compared to the pure control, physical exercise (model one; p-False Discovery Rate (FDR) < 0.01 & < 0.05) with cognitive training (model two; p-FDR =  < 0.001), and all three interventions combined (model four; p-FDR =  < 0.01) demonstrated an increase in FBC between regions of the Default-Mode Network (i.e., hippocampus and angular gyrus). After controlling for false discovery rate, there were no significant correlations between change in connectivity and change in cognitive or physical function. Physical exercise alone appears to be as efficacious as combined interventional strategies in altering FBC, but implications for behavioral outcomes remain unclear.

Prefrontal oxygenation and working memory in patients with type 2 diabetes mellitus following integrated yoga: a randomized controlled trial

AIMS

Type 2 diabetes mellitus (T2DM) alters brain functional and structural connectivity leading to cognitive dysfunction. This study examined the effect of a 12-week yoga intervention on prefrontal cortex (PFC) oxygenation and working memory in patients with T2DM.

METHODS

Fifty participants were randomized into yoga and waitlist control groups. The yoga protocol specific to T2DM was followed. The pre- (day 1), mid- (6 weeks) and post-intervention (12 weeks) assessments included measurement of PFC oxygenation while performing working memory tasks (n-back) using functional near-infrared spectroscopy.

RESULTS

Following a 12-week intervention, the yoga group showed improved performance in working memory [accuracy (geometric mean difference of 3.15%, 95% CI [2.33,3.96], p = 0.001) and reaction time (mean difference of 100.8 milliseconds,95% CI [- 166.6, - 35.1], p = 0.002] in the high task load (2-back) associated with higher oxygenation in dorsolateral PFC (β coefficient mean difference of 95.6, 95% CI [0.23,191], p = 0.049) and ventrolateral PFC (β coefficient mean difference of 53.4, 95% CI [7.8,98.9], p = 0.018) regions. Higher oxygenation in dorsolateral PFC during 2-back task was positively correlated with accuracy (r(23) = 0.65, p < 0.001) and negatively correlated with reaction time (r(23) =  - 0.47,p = 0.017).

CONCLUSION

Integrated yoga practice may improve working memory performance associated with higher PFC oxygenation in patients with T2DM. As 12 weeks of yoga intervention improved working memory performance, the regular practice of yoga may have the potential to prevent decline of cognitive functions in clinical conditions.

Yoga Impacts Cognitive Health: Neurophysiological Changes and Stress Regulation Mechanisms

Yoga, a physical and contemplative practice, offers the practitioner a unique mind-body exercise experience demonstrating preliminary efficacy in improving cognitive health. We examine the evidence for underlying mechanisms that explain the yoga-cognition relationship in healthy older adults. The cognitive benefits of yoga may be the result of improved stress regulation and neurocognitive resource efficiency that facilitate bidirectional brain-body communication.

A systematic review of the health effects of yoga for people with mild cognitive impairment and dementia

BACKGROUND

Yoga is a mind-body practice that can elicit robust health and wellbeing effects for older adults. As a result, there is increased public and academic interest into the potential benefits of yoga for older people with mild cognitive impairment (MCI) and dementia.

METHODS

Literature searches in five databases (CENTRAL, PubMed and EBSCOHost indexing CINAHL Plus, PsycINFO, Psychology and Behavioural Sciences Collection) were conducted from the databases' date of inception through to 4 September 2020 to identify pre-post single and multigroup studies of yoga-based interventions involving people with MCI or dementia. Effects on cognitive, mental, and physical health were evaluated, as was safety and study quality.

RESULTS

Database searches identified 1431 articles. Of these, 10 unique studies met inclusion criteria (total 421 participants). Four studies each implemented Kundalini yoga and chair yoga, while two employed Hatha yoga. Most programs ran for 12 weeks (n = 5) and compared yoga to a control group (n = 5). Most studies reported improved cognition, mood, and balance. However, these effects were marred by the high risk of bias identified in all articles. Four studies assessed safety, with one instance of dizziness reported.

CONCLUSIONS

In this emerging field, these studies show that yoga may be safe and beneficial for the wellbeing of people with MCI or dementia. More high quality randomised controlled trials are needed to improve the evidence-base and overcome the limitations of existing studies.

Impact of Yoga Versus Memory Enhancement Training on Hippocampal Connectivity in Older Women at Risk for Alzheimer's Disease

BACKGROUND

Yoga may be an ideal early intervention for those with modifiable risk factors for Alzheimer's disease (AD) development.

OBJECTIVE

To examine the effects of Kundalini yoga (KY) training versus memory enhancement training (MET) on the resting-state connectivity of hippocampal subregions in women with subjective memory decline and cardiovascular risk factors for AD.

METHODS

Participants comprised women with subjective memory decline and cardiovascular risk factors who participated in a parent randomized controlled trial (NCT03503669) of 12-weeks of KY versus MET and completed pre- and post-intervention resting-state magnetic resonance imaging scans (yoga: n = 11, age = 61.45±6.58 years; MET: n = 11, age = 64.55±6.41 years). Group differences in parcellated (Cole-anticevic atlas) hippocampal connectivity changes (post- minus pre-intervention) were evaluated by partial least squares analysis, controlling for age. Correlations between hippocampal connectivity and perceived stress and frequency of forgetting (assessed by questionnaires) were also evaluated.

RESULTS

A left anterior hippocampal subregion assigned to the default mode network (DMN) in the Cole-anticevic atlas showed greater increases in connectivity with largely ventral visual stream regions with KY than with MET (p < 0.001), which showed associations with lower stress (p < 0.05). Several posterior hippocampal subregions assigned to sensory-based networks in the Cole-anticevic atlas showed greater increases in connectivity with regions largely in the DMN and frontoparietal network with MET than with KY (p < 0.001), which showed associations with lower frequency of forgetting (p < 0.05).

CONCLUSION

KY training may better target stress-related hippocampal connectivity, whereas MET may better target hippocampal sensory-integration supporting better memory reliability, in women with subjective memory decline and cardiovascular risk factors.

Effects of mind-body exercises on cognitive impairment in people with Parkinson's disease: A mini-review

Parkinson's disease (PD) is an important health problem caused by the degeneration of brain neurons. Bradykinesia and lower balance ability seriously affect the quality of life of people with PD. Non-motor symptoms, such as cognitive impairment, accompany the course of the disease but still lack sufficient attention. In general, drugs combined with cognitive training are the most common ways to improve cognitive impairment in people with PD. However, long-term use of psychiatric drugs may lead to side effects such as brain death and movement disorders. Recently, mindfulness has been used by researchers in the treatment of cognitive impairment, because healthy older adults who engage in mind-body exercises for a long time have higher cognitive levels than normal aging populations. Mind-body exercise, as a therapy that combines concentration, breath control, and physical activity, is beneficial for improving practitioners' brain and mental health. Mind-body exercises such as Tai Chi, yoga, dance, and Pilates can improve cognitive performance in older adults with or without cognitive impairment. Therefore, mind-body exercise may be a feasible strategy for the treatment of cognitive impairment in people with PD. This study summarizes the latest evidence that mind-body exercises including Tai Chi, Qigong, yoga, and dance improve cognitive impairment associated with PD. We also explored the limitations of current mind-body exercise research, aiming to provide new ideas for improving mind-body exercise as a strategy to alleviate cognitive impairment in people with PD.

Mindfulness-Based Interventions for Older Adults with Dementia or Mild Cognitive Impairment: A Meta-Analysis

OBJECTIVES

This systematic review and meta-analysis examined the effects of mindfulness-based interventions (MBIs) on psychological symptoms, cognitive functions, and quality of life in older adults with dementia or mild cognitive impairment (MCI).

METHODS

A comprehensive search was conducted within four databases to identify relevant randomized controlled trials (RCTs). Heterogeneity was assessed using the I² statistic. Depending on I² statistic values, either a random effects model or fixed effects model was used.

RESULTS

10 RCTs published in 11 articles met the eligibility criteria. The present meta-analysis study found no significant effect of MBIs on depressive symptoms, anxiety, quality of life, memory, and overall cognitive functions compared to control groups.

CONCLUSIONS

Future high-quality studies involving different types of MBIs are needed to better understand the effects of MBIs on psychological symptoms, quality of life, and cognitive functions in older adults with MCI and dementia and examine effective intervention features.

CLINICAL IMPLICATIONS

There is insufficient evidence to determine whether or not practitioners should be routinely providing MBIs to older adults with MCI and dementia due to the lack of studies currently.

Impact of social isolation and coping strategies in older adults with mild cognitive impairment during the covid-19 pandemic: A qualitative study

OBJECTIVES

The objective of this study was to explore the experiences and feelings of older adults with MCI during the COVID-19 outbreak in Chile and to know what strategies they used to overcome social isolation.

METHOD

A qualitative design was used. Ten participants with a diagnosis of MCI took part in this study. All interviews were recorded and coded using thematic analysis.

RESULTS

The thematic analysis identified three themes related to the quarantine experience of older adults with MCI diagnosis: (1) Effects of social isolation during the COVID-19 pandemic (2) Believes, feelings and behaviors about the SARS-CoV-2 virus (3) Coping with social isolation/response to difficulties during the pandemic. It was found that older adults with MCI have been mainly psychologically and socially affected by social distancing and isolation, particularly individuals who were alone during COVID-19 outbreak. The only physical dimension negatively affected was the level of activity. Social isolation led to a significant number of negative emotions such as anger, fear of contracting the virus or possibility of contagion for their families, worries and sadness as well as emotional loneliness. It is noteworthy that the majority of participants have used several coping strategies during this challenging time.

CONCLUSION

Since social isolation and a sedentary life have been associated with poorer cognition and functionality in people with MCI, a rational plan to both prevent the progression of cognitive decline and to increase social contact, is essential. Special attention must be drawn to maintaining people physically active at home and keeping their daily routine (within the possibilities) and also to ensure social connectedness through technology. Implementation of these measures could potentially reduce negative emotions during the pandemic.

Effects of Hatha yoga on cognitive functions in the elderly: a cross-sectional study

This study aimed to investigate the effects of Hatha yoga practice on cognitive functions in the elderly. Thirty healthy older men participated in this study. They belonged to 2 groups. The first group included 15 Hatha yoga practitioners for at least 2 years. The control group involved 15 male older adults who shared the same characteristics (age, years of formal education, and level of physical activity) as the Hatha yoga group but were naive to yoga, meditation, or any mind-body intervention. Neuropsychological tests were applied to measure selective attention, sustained attention, episodic memory, and processing speed. The following tests were administered: The French adaptation of the Victoria Stroop test, the Zazzo's Cancellation Task, the Five Word Test, and a battery of computerized tests to evaluate reaction time. Long-term Hatha yoga practice showed promising results related to executive functions and reaction time, but no significant difference was found between the two groups in episodic memory and sustained attention although a trend of improvement was observed in favor of Hatha yoga practitioners. In conclusion, long-term Hatha yoga practitioners have better cognitive abilities compared to the control group in certain aspects of cognitive functions. Further physiological and psychological variables need to be examined in order to highlight the correlation between yoga intervention and cognitive performance.

A Randomized Controlled Trial of Tai Chi Chih or Health Education for Geriatric Depression

OBJECTIVES

Geriatric depression is difficult to treat and frequently accompanied by treatment resistance, suicidal ideations and polypharmacy. New adjunctive mind-body treatment strategies can improve clinical outcomes in geriatric depression and reduce risk for side-effects of pharmacological treatments.

METHODS

We conducted a 3-month randomized controlled trial to assess the efficacy and tolerability of combining Tai Chi Chih (TCC) or Health Education and Wellness training (HEW) with the stable standard antidepressant treatment on mood and cognitive functioning in depressed older adults (NCT02460666). Primary outcome was change in depression as assessed by the Hamilton Rating Scale for Depression (HAM-D) post-treatment. Remission was defined as HAM-D ≤ 6; naturalistic follow-up continued for 6 months. We also assessed psychological resilience, health-related quality of life and cognition.

RESULTS

Of the 178 randomized participants, 125 completed the 3-month assessment and 117 completed the 6-month assessment. Dropout and tolerability did not differ between groups. Remission rate within TCC was 35.5% and 33.3%, compared to 27.0% and 45.8% in HEW, at 3 and 6 months respectively (χ²(1) = 1.0, p = 0.3; χ²(1) = 1.9, p =0.2). Both groups improved significantly on the HAM-D at 3 and 6 months. TCC demonstrated a greater improvement in general health compared to HEW.

CONCLUSIONS

Both TCC and HEW combined with a standard antidepressant treatment improved symptoms of depression in older adults. While TCC was superior to HEW in improving general health, we did not find group differences in improvement in mood and cognition.

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

BACKGROUND

Female sex, subjective cognitive decline (SCD), and cardiovascular risk factors (CVRFs) are known risk factors for developing Alzheimer's disease (AD). We previously demonstrated that yoga improved depression, resilience, memory and executive functions, increased hippocampal choline concentrations, and modulated brain connectivity in older adults with mild cognitive impairment.

OBJECTIVE

In this study (NCT03503669), 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).

METHODS

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. Right hippocampal volume increased after yoga but did not survive corrections.

CONCLUSION

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.

Alterations in Functional Connectivity Measured by Functional Magnetic Resonance Imaging and the Relationship With Heart Rate Variability in Subjects After Performing Orgasmic Meditation: An Exploratory Study

Background: We measured changes in resting brain functional connectivity, with blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI), associated with a creative meditation practice that is augmented by clitoral stimulation and is designed to not only achieve a spiritual experience but to help individuals manage their most intimate personal relationships. Briefly, the meditative state is attained by both the male and female participants while the male stimulates the woman’s clitoris. The goal of this practice, called orgasmic meditation (OM), according to the practitioners is not sexual, but to use the focus on clitoral stimulation to facilitate a meditative state of connectedness and calm alertness between the two participants.

Methods: fMRI was acquired on 20 pairs of subjects shortly following one of two states that were randomized in their order – during the OM practice or during a neutral condition. The practice is performed while the female is lying down on pillows with the clitoris exposed. During the practice, the male performs digital stimulation of the clitoris for 15 min. Resting BOLD image acquisition was performed at completion of the practice to assess changes in functional connectivity associated with the performance of the practice.

Results: The results demonstrated significant changes (p < 0.05) in functional connectivity associated with the OM compared to the neutral condition. For the entire group there was altered connectivity following the OM practice involving the left superior temporal lobe, the frontal lobe, anterior cingulate, and insula. In female subjects, there was altered connectivity involving the cerebellum, thalamus, inferior frontal lobe posterior parietal lobe, angular gyrus, amygdala and middle temporal gyrus, and prefrontal cortex. In males, functional connectivity changes involved the supramarginal gyrus, cerebellum, and orbitofrontal gyrus, cerebellum, parahippocampus, inferior temporal gyrus, and anterior cingulate.

Conclusion: Overall, these findings suggest a complex pattern of functional connectivity changes occurring in both members of the couple pair that result from this unique meditation practice. The changes represent a hybrid of functional connectivity findings with some similarities to meditation based practices and some with sexual stimulation and orgasm. This study has broader implications for understanding the dynamic relationship between sexuality and spirituality.

Sensory Processing Sensitivity Predicts Individual Differences in Resting-State Functional Connectivity Associated with Depth of Processing

BACKGROUND

Sensory processing sensitivity (SPS) is a biologically based temperament trait associated with enhanced awareness and responsivity to environmental and social stimuli. Individuals with high SPS are more affected by their environments, which may result in overarousal, cognitive depletion, and fatigue.

METHOD

We examined individual differences in resting-state (rs) brain connectivity (using functional MRI) as a function of SPS among a group of adults (M age = 66.13 ± 11.44 years) immediately after they completed a social affective "empathy" task. SPS was measured with the Highly Sensitive Person (HSP) Scale and correlated with rs brain connectivity.

RESULTS

Results showed enhanced rs brain connectivity within the ventral attention, dorsal attention, and limbic networks as a function of greater SPS. Region of interest analyses showed increased rs brain connectivity between the hippocampus and the precuneus (implicated in episodic memory); while weaker connectivity was shown between the amygdala and the periaqueductal gray (important for anxiety), and the hippocampus and insula (implicated in habitual cognitive processing).

CONCLUSIONS

The present study showed that SPS is associated with rs brain connectivity implicated in attentional control, consolidation of memory, physiological homeostasis, and deliberative cognition. These results support theories proposing "depth of processing" as a central feature of SPS and highlight the neural processes underlying this cardinal feature of the trait.

Connecting Mind-Body Therapy-Mediated Effects to Pathological Features of Alzheimer's Disease

Alzheimer's disease (AD) is a complex, multifactorial neurodegenerative disorder that represents a major and increasing global health challenge. In most cases, the first clinical symptoms of AD are preceded by neuropathological changes in the brain that develop years to decades before their onset. Therefore, research in the last years has focused on this preclinical stage of AD trying to discover intervention strategies that might, if implemented effectively, delay or prevent disease progression. Among those strategies, mind-body therapies such as yoga and meditation have gained increasing interest as complementary alternative interventions. Several studies have reported a positive impact of yoga and meditation on brain health in both healthy older adults and dementia patients. However, the underlying neurobiological mechanisms contributing to these effects are currently not known in detail. More specifically, it is not known whether yogic interventions, directly or indirectly, can modulate risk factors or pathological mechanisms involved in the development of dementia. In this article, we first review the literature on the effects of yogic practices on outcomes such as cognitive functioning and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia. Then, we analyze how yogic interventions affect different risk factors as well as aspects of AD pathophysiology based on observations of studies in healthy individuals or subjects with other conditions than dementia. Finally, we integrate this evidence and propose possible mechanisms that might explain the positive effects of yogic interventions in cognitively impaired individuals.

Preventing Loss of Independence through Exercise (PLIÉ): A Pilot Trial in Older Adults with Subjective Memory Decline and Mild Cognitive Impairment

BACKGROUND

Preventing Loss of Independence through Exercise (PLIÉ) is a group movement program initially developed for people with mild-to-moderate dementia that integrates principles from several well-established traditions to specifically address the needs of people with cognitive impairment.

OBJECTIVE

To investigate whether PLIÉ would benefit cognitive and behavioral outcomes and functional brain connectivity in older adults with milder forms of cognitive impairment.

METHODS

Participants (≥55 y) with subjective memory decline (SMD) or mild cognitive impairment (MCI) were assessed with tests of cognitive and physical function, self-report questionnaires, and resting state functional magnetic resonance imaging (rs-fMRI) on a 3 Tesla scanner before and after participating in twice weekly PLIÉ classes for 12 weeks at the San Francisco Veterans Affairs Medical Center.

RESULTS

Eighteen participants completed the pre-post intervention pilot trial. We observed significant improvements on the Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog; effect size 0.34, p = 0.002) and enhanced functional connections between the medial prefrontal cortex (mPFC) and other nodes of the default mode network (DMN) after PLIÉ. Improvements (i.e., lower scores) on ADAS-cog were significantly correlated with enhanced functional connectivity between the mPFC and left lateral parietal cortex (Spearman's ρ= -0.74, p = 0.001) and between the mPFC and right hippocampus (Spearman's ρ= -0.83, p = 0.001). After completing PLIÉ, participants reported significant reductions in feelings of social isolation and improvements in well-being and interoceptive self-regulation.

CONCLUSION

These preliminary findings of post-PLIÉ improvements in DMN functional connectivity, cognition, interoceptive self-regulation, well-being and reduced feelings of social isolation warrant larger randomized, controlled trials of PLIÉ in older adults with SMD and MCI.

Neural Alterations in Interpersonal Distance (IPD) Cognition and Its Correlation with IPD Behavior: A Systematic Review

Background. Interpersonal distance (IPD) plays a critical role in a human being’s social life, especially during interpersonal interaction, and IPD is non-verbal social information and not only provides silent cues but also provides a secure space for personal relationships. IPD has been a research field of neural studies from the recent decade, researches had provided behavior and neural correlates of IPD. Objectives. This review aims to summarize the experimental paradigms of IPD-neural research, to reveal the neural activity processes associated with it, and to explore the correlation between IPD-neural activity and IPD-behavior. Methods. We conducted a standardized systematic review procedure, including the formal search method be adopted to seek out any type of studies related to IPD and brain, then devised them into categories to make a systematic review. Results. 17 articles met the inclusion criteria of the review, 5 event-related potential (ERP) studies measured the amplitude and latencies of ERPs, and 12 functional magnetic resonance imaging (fMRI) studies provided the neural activation during IPD tasks. In addition, the passive IPD experimental paradigm is the main experimental paradigm for exploring neural activity in IPD cognition, with the parietal lobe, motor areas, prefrontal lobe, and amygdala being the main brain areas involved. Functional connections between the identified brain regions were found and have a moderate correlation with IPD behavior. Conclusions. This review provides the neural activity of the IPD interaction process. However, the insufficient ecological validity of IPD tasks and ignore the initiative of people in IPD interaction. Therefore, there is a large research space on this topic. The work of the current systematic review contributed to linking the external performance and inner neural activities of IPD.

Alzheimer's and Consciousness: How Much Subjectivity Is Objective?

Does Alzheimer Disease show a decline in cognitive functions that relate to the awareness of external reality? In this paper, we will propose a perspective that patients with increasing symptoms of AD show a change in the awareness of subjective versus objective representative axis of reality thus consequently move to a more internal like perception of reality. This paradigm shift suggests that new insights into the dynamicity of the conscious representation of reality in the AD brain may give us new clues to the very early signs of memory and self-awareness impairment that originates from, in our view the microtubules. Dialog between Adso and William, in Umberto Eco's The Name of the Rose, Third Day: Vespers. "But how does it happen," I said with admiration, "that you were able to solve the mystery of the library looking at it from the outside, and you were unable to solve it when you were inside?" "Thus, God knows the world, because He conceived it in His mind, as if it was from the outside, before it was created, and we do not know its rule, because we live inside it, having found it already made."

Movement-based mind-body practices and cognitive function in middle-aged and older adults: Findings from the Midlife in the United States (MIDUS) study

OBJECTIVES

Cognitive function is a key component of healthy aging. While conventional physical activities (walking, jogging, etc.) have been shown to support physical and cognitive health in late-life, it remains unclear whether traditional Eastern movement-based mind-body practices (MBP) have long-term cognitive benefits above and beyond conventional leisure physical activities. This study examines the relationship between movement-based MBP and cognitive function in middle-aged and older adults during a 10-year follow-up period.

METHODS

We used data from Waves 2 (2004-05) and 3 (2013-14) of the Midlife in the United States (MIDUS) study. MIDUS initially surveyed a national probability sample of community-living adults aged 24-75 years in 1995 (Wave 1). Tests of cognitive functioning measuring executive function and episodic memory were added in Wave 2 and repeated in Wave 3. We estimated multivariable linear regression models to examine the effect of MBP (Wave 2) on the episodic memory and executive function (Wave 3) while controlling for covariates (sociodemographic factors, health, and cognitive function at Wave 2).

RESULTS

A total of 2097 individuals aged 42-92 years (M = 64 ± 11, 56 % women) were included. After controlling for sociodemographic factors, health and functional status, and prior levels of cognitive function, engaging in MBP was independently associated with a smaller decline in episodic memory (b = 0.11, p = .03), but not executive function (b=0.03, p = .34).

DISCUSSION

The findings provide the first large population-based evidence supporting the cognitive benefits of MBP over a 10-year period among middle-aged and older adults. Future research should examine whether MBP are effective non-pharmacological intervention to attenuate age-related cognitive decline.

The effect of physical exercise on functional brain network connectivity in older adults with and without cognitive impairment. A systematic review

INTRODUCTION

Neurodegeneration is a biproduct of aging that results in concomitant cognitive decline. Physical exercise is an emerging intervention to improve brain health. The underlying neural mechanisms linking exercise to neurodegeneration, however, are unclear. Functional brain network connectivity (FBNC) refers to neural regions that are anatomically separate but temporally synched in functional signalling. FBNC can be measured using functional Magnetic Resonance Imaging (fMRI) and is affected by neurodegeneration.

METHODS

We conducted a systematic review using PubMed and EMBASE to assess the effect of physical exercise on FBNC in older adults with and without cognitive impairment.

RESULTS

Our search yielded 1474 articles; after exclusion, 13 were included in the final review, 8 of which focused on cognitively healthy older adults. 10 studies demonstrated an increase in FBNC post-exercise intervention, while 11 studies showed improvements in secondary outcomes (cognitive and/or physical performance). One study showed significant correlations between FBNC and cognitive performance measures that significantly improved post-intervention.

DISCUSSION

We found evidence that physical exercise increases FBNC. When assessing the association between FBNC with physical and cognitive functioning, careful consideration must be given to variability in exercise parameters, neural regions of interest and networks examined, and heterogeneity in methodological approaches.

Effects of Mind-Body Exercise on Brain Structure and Function: A Systematic Review on MRI Studies

Mind–body exercise has been proposed to confer both physical and mental health benefits. However, there is no clear consensus on the neural mechanisms underlying the improvements in health. Herein, we conducted a systematic review to reveal which brain region or network is regulated by mind–body exercise. PubMed, Web of Science, PsycINFO, SPORTDiscus, and China National Knowledge Infrastructure databases were systematically searched to identify cross-sectional and intervention studies using magnetic resonance imaging (MRI) to explore the effect of mind–body exercise on brain structure and function, from their inception to June 2020. The risk of bias for cross-sectional studies was assessed using the Joanna Briggs Institute (JBI) checklist, whereas that of interventional studies was analyzed using the Physiotherapy Evidence Database (PEDro) scale. A total of 15 studies met the inclusion criteria. Our analysis revealed that mind–body exercise modulated brain structure, brain neural activity, and functional connectivity, mainly in the prefrontal cortex, hippocampus/medial temporal lobe, lateral temporal lobe, insula, and the cingulate cortex, as well as the cognitive control and default mode networks, which might underlie the beneficial effects of such exercises on health. However, due to the heterogeneity of included studies, more randomized controlled trials with rigorous designs, similar measured outcomes, and whole-brain analyses are warranted.

Preventing dementia? Interventional approaches in mild cognitive impairment

Mild cognitive impairment (MCI) is defined as an intermediate state between normal cognitive aging and dementia. It describes a status of the subjective impression of cognitive decline and objectively detectible memory impairment beyond normal age-related changes. Activities of daily living are not affected. As the population ages, there is a growing need for early, proactive programs that can delay the consequences of dementia and improve the well-being of people with MCI and their caregivers. Various forms and approaches of intervention for older people with MCI have been suggested to delay cognitive decline. Pharmacological as well as non-pharmacological approaches (cognitive, physiological, nutritional supplementation, electric stimulation, psychosocial therapeutic) and multicomponent interventions have been proposed. Interventional approaches in MCI from 2009 to April 2019 concerning the cognitive performance are presented in this review.

Twelve-Week Yoga vs. Aerobic Cycling Initiation in Sedentary Healthy Subjects: A Behavioral and Multiparametric Interventional PET/MR Study

Interventional yoga studies with an active control group remain scarce and are important to clarify the underlying neurobiology. We conducted an interventional study in healthy controls using simultaneous positron emission tomography/magnetic resonance (PET/MR) imaging and psychometric scales. Thirty healthy, female volunteers (28.4 ± 8.4 years) participated and were randomly assigned to a 12-week yoga or indoor cycling intervention. Before and after the intervention, [¹⁸F]FDG and [¹¹C]UCB-J PET was performed on a simultaneous GE Signa PET/MR with volumetric imaging. Psychometric scales were evaluated on affect, mindfulness, stress, worrying, self-compassion, and interoceptive awareness. Yoga subjects scored higher on interoceptive awareness compared to baseline (p < 0.001). Cognitive (P = 0.009) and overall cognitive functioning (P = 0.01) improved after the yoga intervention compared to the cycling group. We did not observe significant differences in glucose metabolism, synaptic density, or gray matter (GM) volume. The indoor cycling group did not show changes in psychometric variables, but significant increases in relative glucose metabolism were observed in the parahippocampal/fusiform gyrus and cerebellum (P < 0.001). In conclusion, 12 weeks of yoga practice has significant effects on interoceptive awareness and perceived cognitive function in starters. Longer interventions and/or higher frequency of yoga practice may be needed to detect cerebral metabolic and/or morphologic effects on the macroscopic level.

Spiritual Fitness: A New Dimension in Alzheimer's Disease Prevention

BACKGROUND

Religious and spiritual interventions may have an effect on Alzheimer's disease prevention. Kirtan Kriya meditation has been shown to mitigate the deleterious effects of chronic stress on cognition, reverse memory loss, and create psychological and spiritual wellbeing, which may reduce multiple drivers of Alzheimer's disease risk.

OBJECTIVE

To detail a new concept in medicine called Spiritual Fitness, a merging of stress reduction, basic wellbeing, and psycho/spiritual wellbeing to prevent Alzheimer's disease.

METHODS

The literature on the topics mentioned above is described, including an in-depth discussion on why and how each are critical to advancing the future of Alzheimer's disease prevention. The many negative effects of chronic stress, and the benefits of Kirtan Kriya, are reviewed. The four pillars of basic wellbeing, six practical aspects of psychological wellbeing, and the four new non-sectarian features of spiritual fitness are then disclosed. Moreover, instructions on practicing Kirtan Kriya are offered in the Supplementary Material.

CONCLUSION

Religious and spiritual practices, including Kirtan Kriya, are crucial components in the development of enhanced cognition and well-being, which may help prevent and, in some cases, reverse cognitive decline. The key point of this review is that making a commitment to live a brain longevity lifestyle including spiritual fitness is a critically important way for aging Alzheimer's disease free. We hope that this article will inspire scientists, clinicians, and patients to embrace this new concept of spiritual fitness and make it a part of every multidomain program for the prevention of cognitive disability.

War-Related Mental Health Issues and Need for Yoga Intervention Studies: A Scoping Review

Conflicts and humanitarian crises lead to serious mental health disorders, including depression, anxiety, stress, and cognitive decline. Exposure to these circumstances in early life can lead to the development of disorders such as mild cognitive impairment, dementia, and Alzheimer's disease (AD), for which no treatments are available. In this review, various research papers have been compiled to develop an understanding about mental health of population affected due to wars and conflicts and how stress and depression can accelerate the development of dementia and AD. Due to failure of drugs in the treatment of dementia and AD, yoga and mindfulness-based approach has been proposed for future investigations. Although studies have shown that yoga and mindfulness can be helpful in the management of stress, anxiety, depression, and posttraumatic stress disorder in the war-afflicted areas, limited mechanistic studies in yoga and mindfulness remain the chief cause precluding its clinical application in such warzones. The molecular studies in the field of yoga can be undertaken by targeting these warzones. This review provides a scientific evaluation of mind-body techniques as a justification for mental health rehabilitation in the war-afflicted zones in face of failed clinical trials for various drugs. This may help reduce the risk of developing dementia and AD in this susceptible population.

Effects of yoga-related mind-body therapies on cognitive function in older adults: A systematic review with meta-analysis

OBJECTIVES

Considering dementia has no definite curative intervention available through modern medical management, alternative therapeutic symptomatic interventions are needed urgently. This systematic review with meta-analysis evaluated whether yoga-related practices, as a preventive mind-body therapy, is effective for the management of cognitive decline in older adults.

METHODS

Seven electronic databases (Abstracts in Social Gerontology, Age Line, CINAHL, PsycINFO, PubMed, Scopus, and Web of Science) were searched using specified inclusion criteria to identify original studies that investigated the effects of yoga-related mind-body therapies on cognitive function, in the context of aging. A meta-analysis was also carried out calculating the overall effect sizes, expressed as standardized mean differences (i.e., d).

RESULTS

Twelve studies, including 912 participants (73.9% female; 239 with and 673 without cognitive impairment) were selected for this review; eleven were randomized controlled trials. One study had a high risk of bias and was excluded from the meta-analysis. Studies involved a wide variety of yoga practices with a common focus on meditative postural exercises. Results revealed significant beneficial effects on memory (Cohen's d = 0.38), executive function (Cohen's d = 0.40), and attention and processing speed (Cohen's d = 0.33). No adverse effects were reported.

DISCUSSION

Yoga-related mind-body interventions for older adults appear to be safe, feasible, and effective alternative practice for maintenance of cognitive functions both in age- and disease-related cognitive decline. Practicing yoga can be a useful part of daily routine to maintain cognitive function in older adulthood. Suggestions for further research were discussed.

A randomized control trial of meditation compared to music listening to improve cognitive function for breast cancer survivors: Feasibility and acceptability

BACKGROUND

and Purpose: Many breast cancer survivors (BCS) experience persistent cognitive and psychological changes associated with their cancer and/or treatment and that have limited treatment options. Therefore, the purpose of this study was to explore the feasibility and effects of a Kirtan Kriya meditation (KK) intervention on cognitive and psychological symptoms compared to an attention control condition, classical music listening (ML), in BCS.

MATERIALS AND METHODS

A randomized control trial design was used. Participants completed eight-week interventions. Cognitive function and psychological symptoms were measured at baseline and post-intervention. Mixed analysis of variance models were examined for all cognitive and psychological outcomes.

RESULTS

27 BCS completed the study. Intervention adherence was 88%. Both groups improved in perceived cognitive impairments, cognition related quality of life, verbal memory, and verbal fluency (p's < 0.01). There were no significant group by time effects for cognitive and psychological outcomes, except stress. The ML group reported lower stress at time 2 (p < 0.05).

CONCLUSION

KK and ML are feasible, acceptable, and cost-effective interventions that may be beneficial for survivors' cognition and psychological symptoms. Both interventions were easy to learn, low cost, and required just 12 min/day. Meditation or music listening could offer providers evidence-based suggestions to BCS experiencing cognitive symptoms.

CLINICAL TRIALS REGISTRATION NUMBER

NCT03696056.

Can Adults with Mild Cognitive Impairment Build Cognitive Reserve and Learn Mindfulness Meditation? Qualitative Theme Analyses from a Small Pilot Study

BACKGROUND/OBJECTIVE

High levels of chronic stress negatively impact the hippocampus and are associated with increased incidence of mild cognitive impairment (MCI) and Alzheimer's disease. While mindfulness meditation may mitigate the effects of chronic stress, it is uncertain if adults with MCI have the capacity to learn mindfulness meditation.

METHODS

14 adults with MCI were randomized 2:1 to Mindfulness Based Stress Reduction (MBSR) or a wait-list control group. We conducted qualitative interviews with those who completed MBSR. Transcribed interviews were: a) coded using an emergent themes inductive approach informed by grounded theory; b) rated 0-10, with higher scores reflecting greater perceived benefit from, and understanding of, mindfulness meditation. Ratings were correlated with daily home practice times and baseline level of cognitive function.

RESULTS

Seven themes emerged from the interviews: positive perceptions of class; development of mindfulness skills, including meta-cognition; importance of the group experience; enhanced well-being; shift in MCI perspective; decreased stress reactivity and increased relaxation; improvement in interpersonal skills. Ratings of perceived benefit and understanding ranged from 2-10 (mean = 7) and of 0-9.5 (mean = 6), respectively. Many participants experienced substantial benefit/understanding, some had moderate, and a few had minimal benefit/understanding. Understanding the key concepts of mindfulness was highly positively correlated with ≥20 minutes/day of home practice (r = 0.90) but not with baseline cognitive function (r = 0.13).

CONCLUSIONS

Most adults with MCI were able to learn mindfulness meditation and had improved MCI acceptance, self-efficacy, and social engagement. Cognitive reserve may be enhanced through a mindfulness meditation program even in patients with MCI.

Emerging Complementary and Integrative Therapies for Geriatric Mental Health

PURPOSE

The use of complementary and integrative medicine (CIM) is on the rise among diverse populations of older adults in the USA. CIM is commonly perceived as safer, less expensive, and more culturally acceptable. There is a growing body of evidence to support the use of CIM, especially mind-body therapies, diet and nutritional supplements used for mental disorders of aging.

RECENT FINDINGS

We summarize the results of the recent clinical trials and meta-analyses that provide the evidence for the role of CIM in treating older adults with mood or cognitive disorders that includes the use of diet and supplements, and mind-body therapies.

SUMMARY

Dietary and mind-body therapies have become increasingly popular and show the strongest evidence of efficacy for mood and cognitive disorders. Although the use of vitamins and supplements is the most popular CIM practice, only mixed evidence supports their use with additional concerns for herb (supplement)-drug interactions. Despite increasing use of CIM by the general population, information to guide clinicians providing care for older adults remains limited with variable scientific rigor of the available RCTs for a large number of commonly used CIM interventions for the mental health of older adults.

Effects of Mind-Body Interventions Involving Meditative Movements on Quality of Life, Depressive Symptoms, Fear of Falling and Sleep Quality in Older Adults: A Systematic Review with Meta-Analysis

Background: The aim of the present systematic meta-analytical review was to quantify the effects of different mind–body interventions (MBI) involving meditative movements on relevant psychological health outcomes (i.e., quality of life (QoL), depressive symptoms, fear of falling (FoF) and sleep quality) in older adults without mental disorders. Methods: A structured literature search was conducted in five databases (Ovid, PsycINFO, PubMed, SPORTDiscus, Web of Science). Inclusion criteria were: (i) the study was a (cluster) randomized controlled trial, (ii) the subjects were aged ≥59 years without mental illnesses, (iii) an intervention arm performing MBI compared to a non-exercise control group (e.g., wait-list or usual care), (iv) psychological health outcomes related to QoL, depressive symptoms, FoF or sleep quality were assessed and (v) a PEDro score of ≥5. The interventions of the included studies were sub-grouped into Tai Chi/Qigong (TCQ) and Yoga/Pilates (YP). Statistical analyses were conducted using a random-effects inverse-variance model. Results: Thirty-seven randomized controlled trials (RCTs) (comprising 3224 participants) were included. Small to moderate-but-significant overall effect sizes favoring experimental groups (Hedges’ g: 0.25 to 0.71) compared to non-exercise control groups were observed in all outcomes (all p values ≤ 0.007), apart from one subdomain of quality of life (i.e., social functioning, p = 0.15). Interestingly, a significant larger effect on QoL and depressive symptoms with increasing training frequency was found for TCQ (p = 0.03; p = 0.004). Conclusions: MBI involving meditative movements may serve as a promising opportunity to improve psychological health domains such as QoL, depressive symptoms, FoF and sleep quality in older adults. Hence, these forms of exercise may represent potential preventive measures regarding the increase of late-life mental disorders, which need to be further confirmed by future research.

What Has Neuroimaging Taught Us on the Neurobiology of Yoga? A Review

Yoga is becoming increasingly popular worldwide, with several implicated physical and mental benefits. Here we provide a comprehensive and critical review of the research generated from the existing neuroimaging literature in studies of yoga practitioners. We reviewed 34 international peer-reviewed neuroimaging studies of yoga using magnetic resonance imaging (MRI), positron emission tomography (PET), or single-photon emission computed tomography (SPECT): 11 morphological and 26 functional studies, including three studies that were classified as both morphological and functional. Consistent findings include increased gray matter volume in the insula and hippocampus, increased activation of prefrontal cortical regions, and functional connectivity changes mainly within the default mode network. There is quite some variability in the neuroimaging findings that partially reflects different yoga styles and approaches, as well as sample size limitations. Direct comparator groups such as physical activity are scarcely used so far. Finally, hypotheses on the underlying neurobiology derived from the imaging findings are discussed in the light of the potential beneficial effects of yoga.

Comparison of study samples recruited with virtual versus traditional recruitment methods

Background

Traditionally, clinical studies rely on brick-and-mortar sites to recruit participants. Newer technology-based studies have utilized non-traditional virtual methods that can potentially recruit more diverse populations and shorten recruitment timelines. This manuscript aims to quantify how sample metrics across three virtual studies compare to traditionally recruited samples, as a first step in building an empirical evidence base for the experience of participant recruitment in virtual studies.

Methods

We conducted a systematic search of the literature using PubMed to identify relevant studies conducted in the United States in cognitive health, diabetes, and hypertension (which we called comparator studies) to compare to three virtual studies. For each included study, we extracted participant demographic characteristics and information on recruitment methods and timing. Two investigators independently extracted this data, compared results for consistency, and contacted comparator study authors for clarifications. Characteristics for measurement included age, sex, race/ethnicity, states represented, recruitment time, and recruitment rate.

Results

We identified 19 comparator studies. Virtually recruited samples were slightly younger, had more female participants, and were split on enrollment of racial minorities as compared to comparator studies. Virtually recruited samples were more diverse geographically and recruited faster.

Conclusions

Virtual recruitment may enhance efficiency and enable more individuals to participate in clinical research. To our knowledge, this is the first rigorous and replicable study comparing participant demographic characteristics and recruitment metrics between virtual and traditional recruitment methodologies. Future research should compare a wider range of studies on other metrics such as overall cost of recruitment and quality of participants.

Effect of Moola Bandha (Perineum Contraction), A Yogic Lock on Cognitive Functions of College Students: An Exploratory Study

Academic performance and excellence of college students are mainly depending on their cognitive functions. The purpose of this study was to examine the effectiveness of a yogic lock or hold, Moola bandha (perineum contraction) on cognitive functions of teacher training college students. Twenty-three healthy volunteers with the mean ± standard deviation age of 21.96 ± 1.64 years were recruited from a district institute of education and training (DIET) college, North India. All the subjects were asked to perform Moola bandha for the duration of 30 min a day (15 min in the morning and 15 min in the evening) for a period of 30 days. Assessments were taken before and after the intervention period. Results of this study showed a significant increase in the scores of d2 attention total number, digits span forward and backward test, Stroop tasks (neutral total and correct, congruent total and correct, and incongruent correct), and self-control scale along with a significant reduction in d2 attention (omission, commission, and timings), trail making text A and B duration, and positive and negative affective schedule's negative affect scores compared with its respective baseline. These results suggest that 30 min of daily practice of Moola bandha for 30 days is effective in improving the cognitive functions of teacher training college students.

Older Adults Who Meditate Regularly Perform Better on Neuropsychological Functioning and Visual Working Memory Tests: A Three-month Waitlist Control Design Study with a Cohort of Seniors in Assisted Living Facilities

Background: Neuropsychological functioning and visual working memory are vulnerable to age-related decline. This investigation examines the impact of meditation on the said outcomes for older adults in assisted living facilities. Older adults (N = 136) from four assisted living facilities in Mumbai and Pretoria were randomized into intervention and waitlist control groups.Method: The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) was used as a screening instrument for recruitment (cutoff total index score = 86 ± 4). RBANS, the Simple Object Span Test (SOST), and the Picture Span Test (PST) were used to assess the outcomes. The intervention group underwent a 90-day meditation training complemented with self-practice.Results: Posttest scores of the intervention group were higher. Older adult men, with college degree, middle class, widowed, in fair health, with no diagnosed psychiatric conditions, who attended at least 70 (out of 90) meditation lessons and who self-practiced at least 70 times, gained more from the meditation intervention. Intervention compliance had the strongest effect on posttest outcomes as well as sex and psychiatric morbidities.Conclusion: Meditation intervention needs some refinements for older adult women, with high school education, upper class, currently married, in poor health, with diagnosed anxiety/depression/drug dependence, who attended fewer meditation lessons and self-practiced infrequently.

Yoga for People With Chronic Pain in a Community-Based Setting: A Feasibility and Pilot RCT

The purpose of this feasibility pilot study was to assess benefits of 8 weeks of yoga in people with chronic pain. Participants completed baseline assessments and were randomized to yoga or usual care. Yoga was offered twice a week for 8 weeks. We assessed feasibility and the Brief Pain Inventory (BPI) was the primary outcome, assessing pain-severity and pain interference on daily activities. Eighty-three people were recruited; 67 people completed the study and were included in the analyses. Average age of participants was 50.78 ± 10.43 years and most participants had pain >10 years. The intervention appeared feasible and there were significant improvements (P < .05) in multiple measures for the yoga group, including a decrease in BPI interference scores from 7.15 ± 1.70 to 6.14 ± 2.21 (P = .007). There was a significant difference in body responsiveness and pain management scores between groups at 8 weeks. It appears that yoga was feasible and positively influenced multiple outcome measures for people with chronic pain.

Yoga Effects on Brain Health: A Systematic Review of the Current Literature

Yoga is the most popular complementary health approach practiced by adults in the United States. It is an ancient mind and body practice with origins in Indian philosophy. Yoga combines physical postures, rhythmic breathing and meditative exercise to offer the practitioners a unique holistic mind-body experience. While the health benefits of physical exercise are well established, in recent years, the active attentional component of breathing and meditation practice has garnered interest among exercise neuroscientists. As the scientific evidence for the physical and mental health benefits of yoga continues to grow, this article aims to summarize the current knowledge of yoga practice and its documented positive effects for brain structure and function, as assessed with MRI, fMRI, and SPECT. We reviewed 11 studies examining the effects of yoga practice on the brain structures, function and cerebral blood flow. Collectively, the studies demonstrate a positive effect of yoga practice on the structure and/or function of the hippocampus, amygdala, prefrontal cortex, cingulate cortex and brain networks including the default mode network (DMN). The studies offer promising early evidence that behavioral interventions like yoga may hold promise to mitigate age-related and neurodegenerative declines as many of the regions identified are known to demonstrate significant age-related atrophy.

Yoga-plus exercise mix promotes cognitive, affective, and physical functions in elderly people

Objectives: Increased attention is being paid to Asian medicine in balanced total health care. We investigated the effects of mixed exercise including yoga ('Yoga-plus') among elderly individuals. Methods: A total of 385 subjects (72 males and 313 females, 75.5 ± 8.7 years old) participated in a 12-month (M) exercise program at a health and welfare center, a day service center, and a nursing home. Cognitive, affective, and physical functions, and activities of daily living (ADL), were compared at baseline (0M), 6M and 12M of exercise intervention. Results: Mean scores on the frontal assessment battery, clock drawing test, cube copying test, letter fluency, and category fluency significantly improved after the Yoga-plus intervention, while mini-mental state examination, Hasegawa dementia score-revised, and trail-making test performance were relatively stable. Affective scores on the geriatric depression scale (GDS), apathy scale (AS) and Abe's behavioral and psychological symptoms of dementia were not significantly affected by exercise therapy, but subgroups with higher baseline GDS (GDS ≥ 5) and AS (AS ≥ 16) scores showed a significant improvement after intervention. One-leg standing time and 3-m timed up and go test performance significantly improved after 12M intervention. Discussion: Yoga-plus improved cognitive, affective, ADL, and physical functions in a local elderly population, particularly among below-baseline individuals, indicating the benefits of dementia prevention among elderly individuals.

Greater Anteroposterior Default Mode Network Functional Connectivity in Long-Term Elderly Yoga Practitioners

Large-scale brain networks exhibit changes in functional connectivity during the aging process. Recent literature data suggests that Yoga and other contemplative practices may revert, at least in part, some of the aging effects in brain functional connectivity, including the Default Mode Network (DMN). The aim of this cross-sectional investigation was to compare resting-state functional connectivity of the medial prefrontal cortex (MPFC) and posterior cingulate cortex—precuneus (PCC-Precuneus) in long-term elderly Yoga practitioners and healthy paired Yoga-naïve controls. Two paired groups: yoga (Y-20 women, Hatha Yoga practitioners; practicing a minimum of twice a week with a frequency of at least 8 years) and a control group (C-20 women, Yoga-naïve, matched by age, years of formal education, and physical activity) were evaluated for: Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI), Instrumental Activities of Daily Living (IADL), and open-eyes resting-state functional magnetic resonance imaging (fMRI)—seed to voxel connectivity analysis (CONN toolbox 17.f) with pre-processing—realignment and unwarping, slice-timing correction, segmentation, normalization, outlier detection, and spatial filtering. The analysis included a priori regions of interest (ROI) of DMN main nodes—MPFC and PCC-Precuneus. There was no difference between groups in terms of: age, years of formal education, MMSE, BDI and IADL. The Yoga group had a higher correlation between MPFC and the right angular gyrus (AGr), compared to the controls. Elderly women with at least 8 years of yoga practice presented greater intra-network anteroposterior brain functional connectivity of the DMN. This finding may contribute to the understanding of the influences of practicing Yoga for a healthier cognitive aging process.

Neural Correlates of Suicidality in Adolescents with Major Depression: Resting-State Functional Connectivity of the Precuneus and Posterior Cingulate Cortex

OBJECTIVE

Major depressive disorder (MDD) is associated with suicidal thoughts and behaviors ("suicidality"). Of the three components of Joiner's interpersonal theory of suicide, two involve negatively valenced, self-related beliefs: perceived burdensomeness and thwarted belongingness. However, the neurocircuitry underlying self-processing and suicidality has not been fully explored. This study examined the association between suicidality and the neurocircuitry of regions relevant to self-referential processing in adolescents with depression.

METHOD

Fifty-eight adolescents underwent assessment and a resting-state fMRI scan. Resting-state functional connectivity (RSFC) analyses included two brain regions implicated in self-referential processing: precuneus and posterior cingulate cortex (PCC). Suicidality was measured using the Index of Depression and Anxiety Symptoms. While controlling for depression severity, we conducted whole-brain correlation analyses between suicidality and left and right precuneus and PCC connectivity maps.

RESULTS

Suicidality was positively associated with RSFC between left precuneus and left primary motor and somatosensory cortices, and middle and superior frontal gyri. Suicidality was negatively associated with RSFC between left PCC and left cerebellum, lateral occipital cortex, and temporal-occipital fusiform gyrus.

CONCLUSIONS

Findings of hyperconnectivity stemming from the precuneus and hypoconnectivity from the PCC may reflect maladaptive self-reflection and mentalization. However, additional investigation is warranted to further clarify these relationships.