Many older adults turn to complementary and integrative health approaches, often as a reflection of a healthy self-empowered approach to well-being. Natural products often sold as dietary supplements are frequently used by many older people for various reasons despite safety concerns or a lack of evidence to support their use. Although there is a widespread public perception that the botanical and traditional agents included in dietary supplements can be viewed as safe, these products can contain pharmacologically active compounds and have the associated dangers.
Mind and body practices, including relaxation techniques and meditative exercise forms such as yoga, tai chi, and qi gong are being widely used by older Americans, both for fitness and relaxation, and because of perceived health benefits. A number of systematic reviews point to the potential benefit of mind and body approaches for symptom management, particularly for pain.
The number of older adults is growing worldwide. Research with older adult volunteers is growing, and some extant data is available. There is, however, a need for clinical trials with different symptoms and long-term follow-up to increase the evidence base.
This issue of the digest provides information on complementary and integrative health approaches for conditions clinically relevant to older adults.
Condition and Summary of Current Research
In 2012, the American College of Rheumatology issued recommendations for using pharmacologic and nonpharmacologic approaches for OA of the hand, hip, and knee. The guidelines conditionally recommend tai chi, along with other non-drug approaches such as manual therapy, walking aids, and self-management programs, for managing knee OA. Acupuncture is also conditionally recommended for those who have chronic moderate-to-severe knee pain and are candidates for total knee replacement but are unwilling or unable to undergo surgical repair.
Current clinical practice guidelines from the American Academy of Sleep Medicine recommend psychological and behavioral interventions, such as stimulus control therapy or relaxation therapy, or cognitive behavioral therapy for insomnia (CBT-I), in the treatment of chronic primary and secondary insomnia for adults of all ages, including older adults.
Overall, research suggests that some mind and body approaches, such as yoga, tai chi, and meditation-based programs may provide some benefit in reducing common menopausal symptoms.
There have only been a few studies on the effects of tai chi on cell-mediated immunity to varicella zoster virus following vaccination, but the results of these studies have shown some benefit.
There is evidence that tai chi may reduce the risk of falling in older adults. There is also some evidence that tai chi may improve balance and stability with normal aging and in people with neuro-degenerative conditions, including mild-to-moderate Parkinson’s disease and stroke.
There is some evidence that suggests mind-and-body exercise programs such as tai chi and yoga may have the potential to provide modest enhancements of cognitive function in older adults without cognitive impairment.