Yoga for MCI and dementia: memory, planning and daily life

An MCI yoga trial found gains in planning and mood; memory improved in both groups. Dementia studies also examine test scores and caregiver burden.

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You remember what you need to buy, but pause over which errand to do first. A family member may focus on whether you remembered the shopping list, while the difficulty you notice is putting the day in order. Yoga research has examined this ability to organize a task. In a comparison trial involving people with mild cognitive impairment, the yoga group showed improvement in executive function, the mental abilities used to plan and switch between tasks.[7]

An activity chosen for cognitive health does not have to feel like another session of being asked for the correct answer. Yoga combines movement with breathing and can offer a different way to take part. A systematic review of studies involving people with mild cognitive impairment, or MCI, and dementia reported improvements in cognition, mood and balance.[1] The useful question is which abilities changed, under what conditions, and what those results might mean for the person taking part.

This article focuses on MCI trials, research involving people with dementia and their caregivers, and studies examining changes in brain imaging. Research on memory and attention in healthy older adults is covered separately in this feature’s article on cognition and memory. Here, the aim is to understand an activity alongside the person’s current support, interests and everyday circumstances, while keeping the evidence for benefits separate from claims about preventing dementia.

Memory scores are only part of the picture

Cognition is a broad term for mental abilities, and the studies do not treat every ability as interchangeable. Remembering words, working with shapes and locations, and organizing the steps of a task are measured separately. The MCI comparison trial assessed memory and executive function as different outcomes.[7]

Executive function includes organizing steps around a goal and changing approach when necessary. In everyday language, it is the ability to make a plan and adjust it. Remembering the items on a shopping list and deciding the order of several errands help illustrate the difference between memory and planning.

It would miss part of the evidence to judge yoga only by whether it beats memory exercises. In one trial, memory improved in both the yoga and memory-training groups, while significant improvement in executive function appeared in the yoga group.[7] This suggests that practicing with the body and practicing memory may offer different routes into supporting cognition. For a family choosing an activity, the person’s enjoyment and willingness to return belong in the discussion alongside the test results.

Asking only what someone forgot can miss how they organize their day.

Another ability examined in the research is visuospatial skill: understanding and working with shapes and their positions in space. Thinking about where an object belongs or how it is turned can help make this term concrete. A small MCI yoga trial produced preliminary findings favoring yoga for this area.[11]

The measures also extend beyond cognition. Research involving people with dementia assessed depressive symptoms and caregiver burden as well as the participants’ cognitive performance.[12] A trial involving women who felt that their cognition had declined used both objective memory tests and the women’s own assessments as primary outcomes.[15] A test score, a person’s experience of difficulty and a caregiver’s experience of supporting them each answer a different question. Reading them together gives a fuller account of what participation may mean.

An MCI trial found changes in planning abilities

The central comparison trial enrolled 81 people aged 55 and over with MCI. Participants were randomly assigned to Kundalini yoga or memory enhancement training for a 12-week intervention. The researchers assessed memory, executive function and mood at the start, at 12 weeks and at 24 weeks.[7] Kundalini yoga was the specific form used in this trial. Its results describe that research program, so the details of an ordinary yoga class should be considered separately when choosing a place to practice.

At both 12 and 24 weeks, the yoga and memory-training groups showed significant improvement in memory. Only the yoga group showed significant improvement in executive function. The authors concluded that the yoga group had short- and longer-term improvements in executive function compared with memory enhancement training.[7] The positive finding therefore reaches beyond recalling information to the mental work of organizing and shifting an approach.

The comparison group makes this trial particularly useful. Participants receiving memory enhancement training were taking part in an activity intended to help their cognition; they were not simply waiting without an intervention.[7] Comparing yoga with an active program asks a more specific question about what each activity may contribute. It gives a family considering several options something more informative than a comparison between doing an activity and doing nothing.

For someone who dislikes formal memory practice, this can open a conversation about another kind of activity. The decision need not become a contest in which one approach wins and the other is discarded. Both groups improved in memory, and yoga’s distinctive result concerned executive function.[7] The person’s preferences and existing support can guide the choice, with the study serving as evidence about what was measured rather than a prescription for everyone with MCI.

Mood outcomes added another dimension. At 12 weeks, significant improvements in depressive symptoms and resilience were reported only in the yoga group.[7] Resilience describes the ability to recover or regain footing after difficulty. These outcomes suggest that an activity considered for cognition may also matter for how someone feels about taking part and coping with challenges. They were assessed alongside memory and executive function, allowing the researchers to examine several areas within the same program.

At the beginning of the study, the groups had no significant differences in clinical or demographic characteristics. Mood assessments included apathy as well as depression and resilience.[7] The reported benefits should still be attached to their particular outcomes and timing: depression and resilience at 12 weeks, and memory and executive function at 12 and 24 weeks. Describing all mood measures as improved would go beyond the result reported here.

The follow-up assessment is another reason to pay attention to the planning result. The intervention lasted 12 weeks, but assessment continued to 24 weeks.[7] That gives information beyond the immediate end of the program. It remains a study of specified cognitive and mood outcomes over that period; the later assessment was not presented as proof that dementia had been prevented. The finding supports considering a body-based activity as one option within MCI care and support.

Participation, spatial skills and stress also matter

A separate randomized feasibility trial involved 37 people with amnestic MCI, meaning MCI involving memory difficulties. It compared yoga twice a week for 12 weeks with classes about healthy living.[11] A feasibility trial asks whether people can safely participate, attend and accept a program, as well as examining possible benefits. These questions are practical: a promising activity only becomes useful to a person if participation fits their circumstances.

The trial found a moderate effect size favoring yoga for visuospatial skills and a large effect size for reduced perceived stress. However, the health-education group had the greater reduction in depressive symptoms.[11] An effect size describes the size of a difference rather than simply whether a statistical test identified one. Here, the results provide a specific comparison: yoga looked promising for spatial skills and stress, while the educational activity performed better on another mood outcome.

That less favorable depression finding belongs alongside the benefits. Stress and depressive symptoms are different measures, and an improvement in one does not establish an improvement in the other. A person choosing an activity may value the chance to learn about healthy living as well as the chance to move. This trial offers reasons to consider what each program addresses, rather than assuming every mental-health outcome will favor yoga.[11]

The researchers assessed cognition and mood at the start and immediately after the intervention. They also monitored adverse events, class attendance and satisfaction.[11] This combination looks at both a possible effect and the conditions of taking part. Someone may enjoy a class even if a particular test changes little, while an activity with encouraging test results may still prove hard to organize. Participation information helps families think about that practical side.

Satisfaction was high in both groups, and class attendance was reasonably good. Home practice, however, was low.[11] The difference between attending a scheduled activity and practicing at home is part of the evidence. It should not automatically be turned into a judgment about the participant’s motivation or character. The class and the home can provide different conditions for getting started and following instructions.

A set time, someone explaining the activity and an established place to practice can help a family identify what made a class workable. These are questions to explore with the person, rather than additional effects demonstrated by the trial. If the class was welcome but homework rarely happened, it may be more useful to understand the successful setting than to keep adding reminders. The researchers identified stress reduction as a possible mechanism behind yoga’s effects, providing another question for future work.[11]

Reviews show promise across several abilities

Looking across studies helps place an individual trial in context. A meta-analysis of mind-body exercise, including activities beyond yoga, found that participants with MCI improved more than healthy participants on visuospatial construction and executive tasks.[10] The overall figures and differences between exercise types are addressed in the accompanying article on senior yoga, memory and attention. For this article, the relevant point is that the abilities of interest extend beyond remembering information.

A systematic review specifically examining Kundalini yoga included 5 randomized controlled trials with 215 participants aged 55 and over who had MCI or subjective cognitive decline. It reported promising findings for memory, executive function, mood and brain function.[8] Subjective cognitive decline means that someone experiences a decline in their own thinking. Keeping that description visible helps readers distinguish trials involving self-reported difficulty from trials involving people identified as having MCI.

The trials in that review ranged from 11 to 81 participants and lasted 12 to 24 weeks. Comparison activities included memory enhancement training and psychoeducation.[8] Psychoeducation involves learning about mental or physical health and ways of managing difficulties. These comparisons help researchers ask what a movement-based program contributes when the other participants are also receiving an organized activity, instruction and opportunities to engage.

The review covering both MCI and dementia included 10 studies with 421 participants. Kundalini yoga and chair yoga each accounted for 4 studies, while 2 used Hatha yoga. The most common program duration was 12 weeks, used in 5 studies, and 5 studies included a control group.[1] The term yoga therefore covers several approaches in this literature. It includes activities using a chair, rather than only challenging poses performed while standing.

For a family, those differences are useful starting points when discussing participation. The form of yoga, the instructions and the support used in a study help describe what the participants actually did. A review of several approaches does not create a single standard routine for every person. Understanding the program is part of understanding the result, especially when considering how someone will follow instructions and take part comfortably.

The Kundalini review called for appropriate instruction and gradual progression to support safety.[8] A family member’s role can be to help confirm that the person understands the explanation and that participation is manageable, rather than to score their practice. The review’s promising findings also came with a call for larger, better-designed comparative trials.[8] The evidence provides a reason to explore participation while leaving room for differences in needs, preferences and support.

Numbers: MCI and yoga research

• 81 participants: the MCI comparison trial found memory improvements in both groups and significant executive-function improvement in the yoga group.[7]
• 12 weeks, twice a week: the yoga schedule used in the feasibility trial involving 37 people with MCI.[11]
• 5 trials, 215 participants: the scale of the Kundalini yoga systematic review.[8]
• 10 studies, 421 participants: the scale of the systematic review covering yoga in MCI and dementia.[1]