Yoga for prevention of cognitive decline in older women with cardiovascular risk factors and cognitive decline.

Abstract

AbstractBackgroundYoga may produce positive effects on cognitive functions in older adults at risk for cognitive decline. In this study (NCT03503669), we investigated neural and peripheral biomarkers therapeutic response in older women with subjective cognitive decline (SCD) and cerebrovascular risk factors (CVRFs) following three months of yoga compared to memory enhancement training (MET).MethodWe conducted a randomized, controlled trial to assess the efficacy of Kundalini yoga (YOGA) and memory enhancement training (MET) on mood and cognitive functioning in a group of older women with CVRFs and SCD. RNA sequencing and cytokine/chemokine assays were analyzed as well as a multimodal MRI (Siemens 3T Prisma scanner).ResultA total of 79 patients (YOGA = 40; MET = 39) were randomized and 63 completed the 24‐week follow‐up (Mean age = 66.5 years and mean MMSE was 28.4). At 12‐weeks and 24‐weeks, both interventions demonstrated improvement in frequency of forgetting (MFQ‐Factor 1) (F(1, 76) = 0.2, p = 0.7). At 24‐weeks, YOGA participants demonstrated between‐ and within‐groups improvements in seriousness of forgetting/MFQ‐Factor 2 (effect size (95% confidence interval) = ‐0.73 (‐1.26, ‐0.19)). Compared to MET, at 12‐ and 24‐weeks follow‐up, YOGA uniquely modulated targets related to interferon signaling and innate and adaptive immunity. Compared to YOGA, MET participants displayed higher Eotaxin‐1 levels (F(2,67) = 3.94, p = 0.02). On sMRI‐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. Right hippocampal volume increased after yoga. rs‐fMRI analysis showed a left anterior hippocampal subregion assigned to the default mode network (DMN) with greater increases in connectivity with largely ventral visual stream regions with YOGA than with MET (p<.001), in associations with lower stress (p<.05).ConclusionAt 24‐weeks follow‐up, YOGA yielded a significant, large effect size improvement in subjective cognitive impairment, and a robust mediation of inflammatory‐immune pathways, including suppression of pro‐inflammatory molecules. YOGA also offered neuroprotective effects compared to MET. These results suggest clinical, neural and biological benefits to YOGA for SCD in post‐menopausal women at risk for AD.