Yoga for Patients with Alzheimer's Disease

Authors: Santiago Allende, Louise Mahoney, Jasmin M. Francisco, Korrine Fitz, Audrey Keaney, Kelly Parker-Bridges, Heidi Mahoney, Booil Jo, Jason Greenberg, Peter J. Bayley

Background: Chronic musculoskeletal pain is common in patients with Alzheimer’s disease (AD), and there is growing awareness that chronic pain has an impact on the progression of dementia. Yoga has shown promise in treating chronic pain. However, attending in-person yoga can be difficult for AD patients.

Objective: To assess the feasibility, acceptability and preliminary efficacy of an online yoga (teleyoga) protocol suitable for AD patients with chronic pain, and their caregivers.

Methods: Patients with comorbid mild AD and chronic musculoskeletal pain (n = 15, 57-95 y/o; 73% Female) and their caregivers (n = 15, 50-75 y/o; 67% Female) received 12-weeks of teleyoga individually (n= 5 dyads) or in groups (n=10 dyads). Study measures included standard feasibility metrics, and secondary outcomes included the Brief Pain Inventory-Short Form (BPI-SF), Beck Depression Inventory-II (BDI-II), and cognitive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB). Caregivers also completed measures of caregiver burden, and quality of life (Short Form Health Survey-36, SF-36).

Results: Feasibility measures showed adequate treatment adherence (85.1% in patients and 86.3% in caregivers), acceptability (mean acceptability rating = 3.0 for patients and 3.3 for caregivers, indicating positive approval), recruitment rate (n = 16 dyads within 1-year), retention rate (87%), missing data rate (0.03%), and fidelity of treatment delivery (87%). Following treatment, the AD group showed significant reductions in pain severity (BPI-SF mean Δ = -0.93, p = .045) and depression (BDI-II; mean Δ = -9.85, p = .005). Caregivers showed significant reductions in depression (BDI-II mean Δ = -6.88, p = .036) and fatigue (SF-36 mean Δ = 9.81, p = .021).

Conclusion: Results show that teleyoga is a feasible treatment for patients with comorbid mild AD and chronic musculoskeletal pain. Results also provide preliminary evidence of health benefits of teleyoga for both AD patients and their caregivers.