Elderly

Gregory E Hicks et al. (2024) · The Lancet. Rheumatology

This clinical trial focused on a specific, higher-risk group of older adults with chronic low back pain (LBP): those who also have hip pain and weak hip muscles, a combination the researchers had previously linked to worse pain and disability outcomes over time. Older adults are usually left out of low-back-pain research entirely, so there has been little evidence to guide their care. This trial, called MASH, asked whether physical therapy specifically targeting the hips would work better for this subgroup than standard physical therapy focused on the spine. 184 adults aged 60 to 85 (average age 70) with this hip-and-back pattern were randomly assigned to one of two physical therapy programs, delivered twice a week for eight weeks by trained therapists at three US research sites. One group received hands-on therapy and stretching for the hips plus hip-strengthening and core exercises (hip-focused); the other received hands-on therapy for the lower back plus some of the same core exercises and gentle stationary cycling (spine-focused). Both groups also did home exercises. The two main measures tracked were self-reported back-pain disability (using a standard 0-100 scale) and walking speed, checked at 8 weeks (the main comparison point) and again at 6 months. At 8 weeks, people who got the hip-focused therapy reported meaningfully less disability than those who got spine-focused therapy, though this difference faded by 6 months - not because the hip-focused group got worse, but because the spine-focused group kept catching up. Walking speed improved similarly in both groups the whole time. However, several other measures did favor hip-focused therapy throughout the study: people in that group walked farther in a 6-minute walk test, stood up from a chair more times in 30 seconds by 6 months, and reported less pain and better physical function, mood, and quality of life at 8 weeks. Both treatments were about equally safe, with mostly mild, expected muscle soreness; a small number of more serious health events occurred in each group, but none were linked to the therapy itself. The researchers see this as encouraging evidence that matching physical therapy to a person's specific pattern of hip and back impairments, rather than giving everyone the same generic back-focused program, can produce faster improvement, especially in physical performance. Both approaches were active, hands-on treatments (there was no do-nothing comparison group), participants obviously knew which type of therapy they were receiving, and the 16-session program is a substantial time commitment, so the researchers say more work is needed on cost and on whether a shorter or more flexible version could achieve similar results before this approach could be widely recommended.

Genxiang Mao et al. (2017) · International journal of environmental research and public health

This study asked whether older adults with chronic heart failure (CHF) — a serious condition where the heart struggles to pump blood effectively — might benefit from a short forest retreat. Thirty-six CHF patients aged 65 to 80 from Hangzhou, China, were split into two groups: most went on a 4-day trip to a forest park, while a smaller group stayed in an urban area, under otherwise matched conditions (food, activity, lodging). Both groups walked outdoors twice a day for about 90 minutes at a gentle, unhurried pace — safe enough that a nurse and doctor accompanied the walks — and avoided smoking, alcohol, and caffeine throughout the trip. Blood was drawn before and after to check heart-failure markers, blood vessel and hormone factors related to heart disease, inflammation, and antioxidant status, and everyone completed a standard mood questionnaire (POMS) before and after. After the forest trip, participants had a significantly lower level of BNP, a key blood marker doctors use to gauge heart-failure severity, compared with both their own starting level and the city group — whose BNP didn't change. The forest group also had lower endothelin-1 (a blood-vessel-constricting hormone linked to heart disease) and lower interleukin-6 (an inflammation marker) than the city group, along with signs of less oxidative cell damage. Mood improved significantly in the forest group too — less tension, depression, anger, and confusion — while the city group's mood stayed about the same. The forest site's air was dramatically cleaner: about 30 times more of the negative ions associated with fresher air, and a small fraction of the fine-particle pollution found in the city. These early results suggest that even a short, four-day forest trip may offer measurable benefits in people living with heart failure — studied as a complement to regular medical care, not a replacement for it. The study was small (33 people finished it) and short, tested in only one season, and can't fully separate the effect of the forest itself from other differences like travel, group size, or simply a change of routine. Larger, longer trials are needed before forest bathing becomes a standard recommendation for heart failure patients.

Aibo Li et al. (2025) · Frontiers in public health

This study tested whether spending three days in a forest could help lower blood pressure in older adults who already have essential hypertension (high blood pressure with no single identifiable cause). Thirty-six adults aged 60 to 80 with diagnosed hypertension took part: 24 went to a subtropical forest national park in China for a 3-day retreat, while 12 stayed in the city of Hangzhou following the same daily schedule, so researchers could compare the two settings directly. The forest group took part in daily gentle activities designed to immerse them in nature: eight trigrams boxing (a slow, breath-focused Qigong practice), a few hours of guided forest walking, a traditional tea ceremony, and a meditation session. Both groups ate the same meals and kept the same schedule. Before and after the trip, researchers measured blood pressure, heart rate, blood oxygen, heart-rate variability (a marker of nervous-system balance), several inflammation and stress-hormone markers in the blood, and mood using a standard questionnaire. After the trip, the forest group's blood pressure was significantly lower than the city group's, both the top number (systolic, ~134 vs. 147) and bottom number (diastolic, ~78 vs. 85). Inflammation, measured by a sensitive CRP blood test, was also significantly lower in the forest group. Heart-rate variability shifted in a pattern the researchers interpreted as a healthy autonomic-nervous-system adjustment for this population. On mood, the forest group reported significantly less tension and anxiety and significantly more energy and vitality than the city group; other mood measures trended better but weren't statistically significant. Heart rate, blood oxygen, and most other blood markers (IL-6, cortisol, oxidative-stress markers) didn't differ significantly between the groups. These results suggest a short forest retreat combining gentle nature-based activities may meaningfully help lower blood pressure, ease inflammation, and improve mood in older adults with hypertension, as a complement to standard care. Because the forest program bundled several practices together (forest walking, qigong, meditation, tea ceremony) and compared a larger forest group to a much smaller city group in a different location, it's hard to know how much came from the forest setting itself versus the other activities. The trial only lasted three days, so it can't say whether the benefits last, and larger, longer studies are needed before forest bathing becomes a standard recommendation for hypertension.

Nima Javadzade et al. (2024) · BMC public health

This randomized controlled trial with 60 depressed older adults living in nursing homes in Isfahan, Iran, explored whether an 8-week Mindfulness-Based Stress Reduction (MBSR) program could ease depression, improve emotion regulation, and reduce sleep problems. MBSR is a structured group program, originally developed for stress and chronic illness, that trains people to notice thoughts, emotions, and body sensations without judgment through practices like body scanning and gentle movement. Emotion regulation here covers two distinct skills the study measured separately: cognitive reappraisal (reinterpreting a situation to change its emotional impact) and expressive suppression (holding back outward emotional expression), the latter generally considered a less adaptive coping strategy. Participants, referred by geriatricians and screened with the Geriatric Depression Scale, were randomly split into an MBSR group (30 people, average age 66) and a no-treatment control group (30 people, average age 67); 60% of each group were women. The MBSR group attended eight weekly 90-minute sessions with a certified instructor, practicing body scans, mindful movement, loving-kindness meditation, walking meditation, and mindful eating, plus home practice between sessions. Before the program and one week after it ended, both groups completed the Geriatric Depression Scale, the Emotion Regulation Questionnaire, and the Pittsburgh Sleep Quality Index. After 8 weeks, the MBSR group showed significantly lower depression scores than the control group (adjusted averages 6.28 vs. 8.82, p<0.001), with a large effect size (partial eta squared=0.57, meaning the intervention accounted for over half the variance in the outcome). Emotion regulation shifted favorably on both subscales: cognitive reappraisal rose (22.67 vs. 20.36, p<0.001) while expressive suppression fell (12.32 vs. 15.65, p<0.001, partial eta squared=0.56) — a pattern consistent with Gross's emotion regulation model, in which stronger reappraisal skills reshape an emotional response early, reducing reliance on effortful suppression later. Sleep quality also improved, with lower Pittsburgh Sleep Quality Index scores in the MBSR group (11.58 vs. 13.35, p<0.001), which the authors link to MBSR increasing attentional control over the automatic arousal and rumination that disrupt sleep. All four outcomes reached statistical significance with observed power near 1.00 (a near-certain ability to detect a true effect). For nursing-home psychologists and caregivers, MBSR appears to be a practical, side-effect-free complement to standard depression care for older residents, requiring only a certified instructor and a weekly 90-minute time commitment. Limitations are real: outcomes relied entirely on self-report in a population prone to inaccurate self-assessment, the control group received no intervention at all rather than an active comparison, there was no follow-up beyond one week, and the sample was limited to depressed nursing-home residents in Iran. Future research should add objective measures and longer follow-up before these findings are treated as conclusive.