Background: Yoga, a multicomponent mind-body practice, improves multiple domains of physical and psychological health and may improve frailty in older adults.
Purpose: To evaluate the available trial evidence on the impact of yoga-based interventions on frailty in older adults.
Data Sources: Medline, Embase, and Cochrane Central, from their inception to April 27, 2022.
Study Selection: Randomized controlled trials evaluating the effect a yoga-based intervention, including at least one session of physical postures, on a validated frailty scale or single-item marker(s) of frailty in adults aged 65 years or older.
Data Extraction: Two authors independently screened articles, extracted data, and assessed quality. A third author resolved any disagreements.
Data Synthesis: Thirty-seven studies (n=2,608 participants) of moderate methodological quality (mean PEDro score 5.6) were identified in varied populations including community-dwellers, nursing home residents, and those with chronic disease. Yoga styles were primarily based on Hatha yoga and most often included the Iyengar yoga or chair-based methods. Function, gait speed, handgrip strength, balance, lower extremity strength and endurance, and multicomponent physical performance measures were the most frequently used single-item markers of frailty; no studies included a classic operational definition of frailty. Of 37 trials, 25 (67.5%) showed significant improvements in frailty after a yoga intervention.
Limitations: Heterogeneity in study design and yoga style, small sample sizes, variable study duration, limited post-intervention follow-up.
Conclusions: Yoga improves frailty in older adults and is a promising prevention and management strategy for frailty.