Journal of Traditional Medicine & Clinical Naturopathy
Open Access

Yoga; Caregivers; Dementia; Mental health; Depression

Introduction

Yoga could be an all-encompassing approach to wellbeing and an antiquated hone that's classified as a shape of complementary and elective medication in western culture.1 The Sanskrit root of the term “yoga” is “yuj,” which implies “to yoke” or “combine” as well as to center and coordinate one's attention.2 Persistent yoga hone progresses self-awareness, empowers characteristics of approachability, kindness, and self-control, enhances a sense of tranquillity and wellbeing, and upgrades the sensation of quality to live completely with veritable happiness.3,4 It is an successful strategy for overseeing stretch responses.

To combat stretch, Dr. Jon Kabat-Zinn created the Mindfulness- Based Stretch Decrease (MBSR) program in 1979 which could be an exceedingly created psycho-educational and skill-based treatment program that combines hatha yoga and mindfulness meditation. [1-3] It is utilized for people with different incessant sicknesses such as misery, uneasiness, skin and resistant disarranges, incessant torment, cancer, diabetes mellitus, hypertension, and those looking to progress adapting and diminish stress.18 It was found that mindfulness treatments were compelling at moving forward the wellbeing of dementia caregivers.19, 20, 21 A yoga-based intercession seem increment a caregiver's mental wellbeing by diminishing caregiver stretch, burden, and discouragement. Blended impacts on the mediations were famous. There were no reports of noteworthy unfavorable effects. as yogic hone progresses well-being by bringing down push and boosting mental wellbeing, it can be utilized as a redirection for those who care for people with extreme mental illnesses.

Methods

Utilizing the Cochrane Handbook for Systematic Reviews of Interventions, this systematic review and meta-analysis were conducted. It was then described following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.

Eligibility criteria

The study's eligibility criteria were: (a) Types of participants: participants were caregivers of individuals living with dementia; (b) Types of interventions: interventions that include yoga in any form to reduce caregiver stress and enhance caregiver wellbeing; (c) Types of comparators: comparators with no intervention or intervention other than yoga; (d) Types of outcomes: primary outcomes were: caregiver stress, caregiver mental health, caregiver burden, and caregiver depression; secondary outcomes were (1) heart rate; (2) blood pressure; (3) sleep quality; (4) self-efficacy; (5) quality of life [4].

The studies were excluded if the RCTs included a dyadic group (i.e., caregivers and people living with dementia), study subjects utilizing numerous programs simultaneously, research studies with an unclear explanation of intervention contents, or feasibility studies were also excluded.

Results

The PRISMA flow graphic illustrates the wide search approach (Fig. 1). A preliminary pool of 150 trials was found, and 132 further records were examined for eligibility. After reviewing a total of 13 trials,nine research, totalling 323 participants, were comprised in the metaanalysis. Table 1 provides a summary of all the pertinent information about the included research. Each included study had a sample size ranging from 9 to 145. The participants' ages ranged from 34 to 66.12 years old with an average of 57.01 years. The length of the intervention ranged from three weeks to twelve weeks. Among the 13 studies, one study used multi-center RCT.

Discussion

Dementia is prevalent among older adults and is associated with frequent episodes of memory loss. The person with dementia may not be able to carry out everyday tasks at the advanced stage, may need to be continually watched, and may need full-time care [5-7]. This will result in increased stress and burden in giving care affecting the caregiver's mental health and leading to depression. Numerous researches have shown that yoga is beneficial for improving quality of life and reducing burden, stress, and depression. The effectiveness of yoga therapy as a caregiver intervention for those with dementia was examined in this current study using meta-analysis.

In this systematic review, we sought to determine whether yoga therapy may enhance caregivers’ mental health by lowering stress, burden, and depression. An extensive systematic review of studies published from January 2021 to October 2021 was carried out to analyze the current evidence regarding the effect of yoga therapy on caregiver outcomes among caregivers of people living with dementia. The RCTs that were used in this meta-analysis were conducted in both middle-income and high-income nations.

A total of 13 randomized controlled trials were included and reviewed, of which nine were used in the meta-analysis and four trials were used in the narrative synthesis. According to this meta-analysis, yoga therapy benefits caregivers of people with dementia by enhancing their mental health and by reducing caregiver stress, burden, and depression. Among the four studies included in narrative synthesis, one single study concluded that yoga therapy improves life satisfaction and self-efficacy, another RCT reported that yoga is beneficial in controlling heart rate, systolic and diastolic blood pressure, and sleep quality,56 and another study reported serum cortisol reduction after yoga therapy [8], one study proved that yoga is effective in improving quality of life.58 None of the 13 research found any negative effects of yoga therapy on those who care for dementia patients.

Among the 13 reviewed trials, the majority were conducted in developed countries like USA, and Australia, and hence, results from these studies cannot be directly applied in developing nations like India or other Asian countries as socio-cultural and economic factors may affect the recipient's reaction to the given interventions. Some of the included trials were pilot studies, so, high-quality randomized controlled trials with a larger sample size are necessary to build solid evidence for yoga therapy as an intervention to reduce caregiver stress, caregiver burden [9-10], and caregiver depression, as well as to enhance caregiver mental health in developing nations. There are a few limitations in this systematic review that should be considered while explicating the results. The quality of the evidence was lesser due to the unclear risk of bias, inconsistency, and high heterogeneity among the included studies. The meta-analysis only included a small number of good qualities RCTs. The strength of this systematic review is that this is the first systematic review to examine the impact of yoga therapy on those who care for people with dementia.

Conflict of Interest

The authors declared that there is no conflict of interest

Acknowledgement

None

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