División de Neurosciencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Ciudad de México, México.
Área Académica de Gerontología, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Pachuca de Soto, México.
J Alzheimers Dis. 2021;82(s1):S65-S90. doi: 10.3233/JAD-200743.
Alzheimer's disease (AD) is a complex, multifactorial neurodegenerative disorder that represents a major and increasing global health challenge. In most cases, the first clinical symptoms of AD are preceded by neuropathological changes in the brain that develop years to decades before their onset. Therefore, research in the last years has focused on this preclinical stage of AD trying to discover intervention strategies that might, if implemented effectively, delay or prevent disease progression. Among those strategies, mind-body therapies such as yoga and meditation have gained increasing interest as complementary alternative interventions. Several studies have reported a positive impact of yoga and meditation on brain health in both healthy older adults and dementia patients. However, the underlying neurobiological mechanisms contributing to these effects are currently not known in detail. More specifically, it is not known whether yogic interventions, directly or indirectly, can modulate risk factors or pathological mechanisms involved in the development of dementia. In this article, we first review the literature on the effects of yogic practices on outcomes such as cognitive functioning and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia. Then, we analyze how yogic interventions affect different risk factors as well as aspects of AD pathophysiology based on observations of studies in healthy individuals or subjects with other conditions than dementia. Finally, we integrate this evidence and propose possible mechanisms that might explain the positive effects of yogic interventions in cognitively impaired individuals.
阿尔茨海默病（AD）是一种复杂的、多因素的神经退行性疾病，代表着一个重大且日益严峻的全球健康挑战。在大多数情况下，AD 的最初临床症状之前，大脑中已经出现了神经病理学变化，这些变化在发病前数年甚至数十年就已经开始发展。因此，近年来的研究集中在 AD 的临床前阶段，试图发现干预策略，如果有效实施，可能会延迟或预防疾病进展。在这些策略中，瑜伽和冥想等身心疗法作为补充替代干预措施引起了越来越多的关注。多项研究报告称，瑜伽和冥想对健康老年人和痴呆症患者的大脑健康都有积极影响。然而，导致这些效果的潜在神经生物学机制目前还不是很清楚。更具体地说，目前尚不清楚瑜伽干预是否可以直接或间接地调节痴呆症发展过程中涉及的风险因素或病理机制。在本文中，我们首先回顾了瑜伽练习对轻度认知障碍和痴呆症患者认知功能和神经精神症状等结果的影响的文献。然后，我们根据对健康个体或患有除痴呆症以外的其他疾病的个体的研究观察，分析瑜伽干预如何影响不同的风险因素以及 AD 病理生理学的各个方面。最后，我们整合这些证据，并提出可能的机制来解释瑜伽干预对认知受损个体的积极影响。
