Mind-body exercise best reduces frailty and boosts quality of life in older adults, study finds

New research reveals that mind-body exercise, such as tai chi and yoga, surpasses other workouts in reversing frailty and enhancing daily function for seniors, offering a cost-effective strategy for healthier aging worldwide.

Study: Mind-body training outperforms other physical activities in reducing frailty and enhancing quality of life in older adults: a network meta-analysis. Image Credit: PeopleImages.com – Yuri A / Shutterstock.com

In a recent study published in the Frontiers in Public Health, researchers compare the impact of mind‑body, aerobic, strength, and mixed exercise programs on frailty, daily function, and quality of life (QoL) in older adults.

Current estimates suggest that up to 25% of older adults live with frailty, which is characterized by declining strength, slowed gait, and poor endurance. As the global population continues to age, the prevalence of frailty will continue to rise and negatively impact the lives of community-dwelling older adults, particularly those residing in low- and middle-income countries.

To date, numerous studies have confirmed the benefits associated with physical activity or regular exercise for building resilience to both prevent and reverse frailty. Despite these observations, it remains unclear whether certain physical activity modalities may be more effective in reducing frailty outcomes than others. To this end, the researchers of the current study compared the effects of mind-body training, aerobic training, strength training, and mixed physical activities on frailty, quality of life (QoL), and activities of daily living (ADLs).

About the study

The researchers of the current study reviewed a total of 35 randomized controlled trials (RCTs) that collectively enrolled 2,905 community-dwelling adults, with a mean age of 72 years, 66% of whom were women. The median duration of the study interventions was 18 weeks with two- to seven-hour-long sessions.

Frailty was assessed with the Short Physical Performance Battery (SPPB) or Fried phenotype, whereas ADL was quantified using the Barthel Index or Instrumental Activities of Daily Living (IADL). QoL of the study participants was determined using standardized instruments including the 36-Item Short Form Health Survey (SF-36), SF-12, SF-8, and EuroQol-5 Dimension (Eq-5D).

Study findings

Mind-body training was associated with the most significant reduction in frailty as compared to controls, who exhibited the least improvement. Thereafter, mixed physical activity also improved frailty outcomes, whereas aerobic and strength training provided less significant improvements.

Overall, mind-body training was considered to be 81% more effective in ameliorating frailty in older adults than all other interventions. Mind-body training also led to the most effective QoL improvements as compared to the other exercise interventions.

Compared to aerobic training, aerobic training was associated with more significant improvements in ADLs in up to 74% of cases. Nevertheless, both mind-body training and mixed physical activity similarly improved ADLs, with a modest impact associated with strength training as compared to controls.

The subgroup analyses demonstrated that the efficacy of community programs was similar to that associated with hospital interventions, which supports a shift in policy toward local delivery. Mind-body training sessions of 50‑60 minutes at least three times every week were associated with the greatest improvements.

The observed improvements in frailty measurements persisted across continents, economic strata, and baseline fitness, which confirms the generalizability of this approach. Cost modeling indicated that each quality‑adjusted life year (QALY) gained through mind-body training was one‑third of the price of current pharmacological fall‑prevention programs. Taken together, exercise emerges as a low‑risk pathway to resilience in aging.

Mind-body training emerged as most effective in alleviating frailty and enhancing overall quality of life, making it particularly suitable for severely frail individuals with restricted mobility.”

Conclusions

Exercise modality is a key factor in determining the prescription of movement medicine for seniors. Mind‑body training was associated with consistent and significant improvements in both frailty and QoL outcomes, whereas aerobic workouts are ideal for preserving daily independence. Importantly, mixed physical activity and strength training also offer complementary benefits.

The effects of these exercise modalities exceed clinically meaningful levels, can be easily incorporated into community settings, and are considered both safe and cost‑efficient. The study findings indicate that practitioners should prioritize one-hour sessions that incorporate both mindfulness and exertion with a frequency of at least three sessions each week. Policymakers can invest confidently in local mind‑body sessions, while researchers are encouraged to continue assessing adherence, biological pathways, and cost‑effectiveness.