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Review
. 2024 Jan;23(1):e13986.
doi: 10.1111/acel.13986. Epub 2023 Sep 12.

Holistic frailty prevention: The promise of movement-based mind-body therapies

Julia Loewenthal  1 , Michelle J Berning  2 , Peter M Wayne  3   4 , Elizabeth Eckstrom  5 , Ariela R Orkaby  1   6
Affiliations
Review

Holistic frailty prevention: The promise of movement-based mind-body therapies

Julia Loewenthal et al. Aging Cell. 2024 Jan.

Abstract

Aging is characterized by fundamental cellular and molecular hallmarks that result in physiologic decline of most body systems. This may culminate in frailty, a state of decreased reserve. Because frailty is a state of multisystem dysregulation, multimodal interventions may be necessary to mitigate and prevent progression rather than interventions targeting a single system. Movement-based mind-body therapies, such as tai chi and yoga, are promising multimodal strategies for frailty prevention and treatment given their inherent multicomponent nature. In this review, we summarize the links between hallmarks of aging and frailty and how tai chi and yoga may impact these hallmarks. We review trial evidence for the impact of tai chi and yoga on frailty in older populations and discuss opportunities for future research.

Keywords: aging; frailty; geroscience; mind-body; tai chi; yoga.

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Conflict of interest statement

P.M.W. is the founder and sole owner of the Tree of Life Tai Chi Center. Peter Wayne's interests were reviewed and managed by the Brigham and Women's Hospital and Partner's HealthCare in accordance with their conflict of interest policies. The authors have no other conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Conceptual model of putative frailty attenuation mechanisms. Movement‐based mind–body therapies (e.g., tai chi and yoga) incorporate multimodal practices that impact cellular and molecular hallmarks of aging, aging physiology, and psychosocial health of participants. These effects modulate frailty markers, with emerging evidence that they may improve frailty as measured by two prevailing models, physical phenotype and deficit accumulation.
FIGURE 2
FIGURE 2
Chord diagram displaying results of 35 randomized controlled trials (RCTs) of a movement‐based mind–body therapy (9 tai chi and 26 yoga) with select frailty outcomes. “Active comparator” denotes RCTs with exercise or other active control group; “inactive comparator” denotes RCTs with education, waitlist, or usual care control groups. Frailty outcomes include gait speed, balance, handgrip strength (HGS), lower extremity (LE) strength and endurance, and multicomponent (“multi”) measures (e.g., Short Physical Performance Battery [SPPB]). “+” indicates a statistically significant between‐group improvement in the indicated outcome whereas “no Δ” indicates that there was no difference between groups. The thickness of each “chord” indicates the number of studies with the outcome.
See this image and copyright information in PMC

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