Association of Yoga Practice with Mortality in a Nationally Representative Sample of US Adults

Background: Regular physical activity and select mindfulness practices are associated with improved health. The practice of yoga incorporates both physical activity and mindfulness elements and may have a survival benefit that has not previously been described. We examined the association of self-reported yoga practice with all-cause mortality in a nationally representative sample of US adults.

Methods: Data were obtained from the 2002 and 2007 Alternative Medicine Supplement of the National Health Interview Survey (NHIS) and linked to the National Death Index through the year 2011 (n=50,222 with 4,151 dead at follow-up). NHIS participants were asked if they had engaged in yoga practice in the previous 12 months. Cox regression was then used to model mortality with adjustment for survey design effects, education level, race/ethnicity, gender, age, and number of comorbidities (such as heart disease, diabetes, emphysema, previous stroke, or previous history of cancer). A subset of analyses was conducted with stratification by age group: 1) <25 years; 2) 25-45 years; and 3) >45 years old.

Results: For the overall sample, practicing yoga was associated with significantly reduced mortality (Hazard Ratio: 0.72; 95% Confidence Interval: 0.62-0.85). After stratification by age, the effect was no longer significant for the two youngest groups, however these groups had very few deaths (29 and 305 in the <25 and 25-45 groups, respectively).  In the oldest age group, yoga practice remained a significant predictor of better survival (0.74; 0.63-0.88).

Conclusions: After controlling for the effect of socio-demographic factors as well as the history of serious comorbidities, yoga practice was a significant predictor of reduced mortality in adults 45 and older. We did not find a similar association in those younger than 45 years, however overall lower mortality rates among the younger adults might have prevented us from detecting an association. Improving accessibility of yoga practice may provide a survival benefit to older adults. Future studies can determine if lifetime yoga practice can reduce all-cause mortality for all age groups.