Does yoga reduce the risk of falls in older people?

Nearly a third of people aged over 65 years and over half of people older than 80 have a fall at least once a year. Falls and fall related injuries can be life changing and may result in chronic disability, admission to assisted living, or death. A fall can also precipitate a fear of falling, which may lead to restriction of activity and hence physical deconditioning. This in turn increases the risk of future falls. Clinical guidelines from several countries recommend multifactorial interventions for preventing falls in older people, with exercise as a key component. A recent Cochrane review (108 randomised controlled trials, 23 407 participants) concluded there is strong evidence that well designed exercise programmes reduce the number of falls by about a quarter among older people living in the community. Such programmes also reduce the number of people experiencing one or more falls. Exercise that mainly involved balance and functional training reduced falls. Yoga is a mind-body practice that typically involves a combination of physical postures, breathing exercises, and concentration/meditation. Yoga has become a popular means of promoting physical and mental wellbeing and is shown to improve health related quality of life in older people. Evidence from observational studies suggests it is an acceptable and attractive form of exercise among older people. There are many different types of yoga, each of which places varying emphasis on physical, mental, and spiritual practices. In the West, the term “yoga” often denotes a modern form of hatha yoga, consisting largely of postural exercises performed with the goal of developing strength, balance, and flexibility (see fig 1). Yoga is not recommended specifically in fall prevention guidelines. The effect of yoga on falls in community-dwelling older people is uncertain.