Healthspan, Equanimity, and the Big 3 of Aging with Baxter Bell

What does it mean to age well? In 2026, the conversation has officially shifted from lifespan—how many years we live—to healthspan—how well we live those years. In this episode, host Michele Lawrence sits down with pioneering medical doctor and certified yoga therapist Dr. Baxter Bell to discuss the intersection of Western medicine and yoga.

Baxter shares his personal evolution from working as a busy family physician in the 1990s to stepping onto the mat full-time as a global leader in the yoga therapy community. Together, they dive into the medical science behind why strength, flexibility, and balance are non-negotiable for longevity, how the practice of equanimity translates into a physical felt-sense during times of uncertainty, and the cutting-edge neuro-protective elements of yoga that help prevent Alzheimer's disease. Whether you are navigating your own mid-life transition or supporting clients through the second half of life, this episode offers a masterful blueprint for building a resilient mind and body.

Key Takeaways & Highlights

• The Doctor’s Pivot: Baxter discusses the professional and personal drivers that led him to transition away from full-time family medicine to pursue yoga  as a primary path.
• Healthspan vs. Lifespan: Why modern longevity is about optimizing physical and mental vitality, and how yoga therapy targets the physical "Big 3" (Strength, Flexibility, and Balance) fundamentally differently than a standard gym workout.
• The Anatomy of Longevity: The direct medical connection between maintaining supple, mobile tissues and long-term biological longevity markers.
• Equanimity as Medicine: Moving equanimity out of the realm of philosophy and into a practice for individuals facing difficult medical diagnoses or age-related transitions.
• Neuro-Protection on the Mat: Clinical insights into how a dedicated yoga therapy practice acts as an effective, preventative intervention against cognitive decline and Alzheimer’s disease.

Connect with Dr. Baxter Bell

• Website: BaxterBell.com
• Discover: Explore Baxter's Winter 2026 workshop series, latest courses, and upcoming global retreats.
• Read: Yoga for Healthy Aging: A Guide to Lifelong Well-Being (Co-authored by Dr. Baxter Bell)

Transcript

SPEAKER_01 0:06

Welcome to This Is Yoga Therapy. I'm your host, Michelle Lawrence. Join me as we venture beyond the map into the fascinating intersections of yoga and health. Each episode brings you candid conversations with the visionary leaders and practitioners who are truly shaping this field, sharing their stories, insights, and the profound impact of yoga therapy in action. Hey, it's Michelle. Before we get into today's episode, I just wanted to bring up one thing. If you're enjoying this is Yoga Therapy, the best way to support the show is to like, subscribe, and review. Whether you're watching it on YouTube or listening on your commute, your engagement really helps us scale. So please take 10 seconds to hit that subscribe button or leave a review. It really makes a world of difference. Okay, let's get into today's episode. Well, welcome folks. Welcome back to This Is Yoga Therapy. And today we're joined by a yoga therapist whose work has refined how we look at the second half of life. Dr. Baxter Bell, who's an MD and a certified yoga therapist. He is the co-author of Yoga for Healthy Aging, and he's also a longtime faculty member in the yoga therapy world and yoga teacher training world as well. Baxter was once on the faculty of a 200-hour teacher training program we had in Durango at least 10 years ago. We were just reminiscing about that. And Baxter has spent over three decades investigating the intersection of Western medicine and yoga. And today we're going to explore his personal pivot from family medicine to the yoga mat and his latest work on extending our life span, but more so our health span.

SPEAKER_00 2:06

Yes. Beautiful.

SPEAKER_01 2:08

And it's such a pleasure to be in conversation with you and to have you here today, Baxter. Thank you so much.

SPEAKER_00 2:15

Yeah, it's great to be here, and it's great to see you again after a decade or so.

SPEAKER_01 2:19

Yeah, where does the time go, right? Yes. So many of our listeners are navigating their own transitions between traditional professions and yoga therapy. I see that a lot, especially lately. And most of our students in a yoga therapy school are women and they are maybe 50s or 60s. I've noticed a lot of that, looking kind of for a second career in yoga therapy. And so you were a busy family physician in the 90s. You weren't in your 50s at that time. And you first fell in love with yoga and then pursued it as a professional path. So talk to us just about your own personal story there. What were the drivers behind that shift?

SPEAKER_00 3:03

Um, well, thanks. I I'll I'll talk about some of those drivers in a second. I just wanted to share with you that I was uh just down at the Shivananda Ashram in the Bahamas teaching, and one of the women that was in the teacher training program that I was uh offering some anatomy and physiology lectures came up and asked if I would talk about her professional path. And she had been a physician in South Africa. She moved to the United States and she um, I think she works for the World Bank. And but but she also is very interested in, you know, parlaying her medical experience. She's no longer practicing medicine in the United States, but you know, just very interested in, you know, how do I make that transition using my past experience and and the really useful tools that came with her uh medical education and as she kind of moves into the world of yoga and possibly yoga therapy. So I just had this conversation like two weeks ago, which was really great. And you know, it gave me an opportunity to revisit my own path and think about the things that were the important factors. You know, one of the things I'll mention about my time as a physician is it was a very busy time of life. I was in a small practice when I first started. There were just three family doctors in the practice, so I was one of three people. And we had evening call that we had to cover. So someone had to be on call every night of the week, and we had weekend call where someone took Friday night to Monday morning on. And so there was there was all that kind of time pressure, uh, lots of busyness. We had a very, very active practice, lots and lots of patients. And there was something exciting about that. I was new to medicine and I was still learning when I first started in uh in 1989, 1990 was my transition year out of residency. So, you know, I really enjoyed the challenge. I loved the people I worked with. I loved family medicine because I got to work with newborns and kids and teenagers and parents and grandparents, kind of the whole spectrum, uh, which is, I think, has served me well as I've kind of moved into yoga and I have a diversity of people in my classes. Now, the youngest person I've ever had in class, I think, is like five or six, and not very often because I don't teach kids generally, right? But I've also had people in their 90s in class, right? So, in fact, in a room just like yours in Sheridan, Wyoming, there was a family, there was a surgeon, a doctor, who got intrigued by the fact that there was this doctor coming to town teaching yoga, and he was retired. But his daughter was also a yoga teacher, and she said he wanted to come to class. Now he was in his 90s. He lived to be, I believe, over 100. And um he he came for many years and we set him up in a chair and he would try stuff, and it was really, really lovely to see someone so steeped in kind of traditional Western medicine, still interested enough to come and check it out.

SPEAKER_01 5:49

So cool.

SPEAKER_00 5:50

So cool, yeah. That was a little bit of a side run. We went down there for a second. But as I started to get into my practice, the other side of practicing medicine, especially in the 90s when I was really uh in my full-time practice, was there was just a lot of other pressures there. There were a lot of demands on uh when it came to insurance billing and things that really took you away from actually caring for patients. And my small group grew over the 10 years that I was in practice. We ended up becoming part of a much larger corporate entity with the hospital that we uh admitted to and uh a primary care practice, and the hospital formed a new entity, and I was involved in being on the board for that. So, anyway, long story short, I got a little burnt out. And at the same time, I had started practicing yoga in the mid-mid 90s, maybe a little bit before that, I started to take class somewhat regularly and then more regularly. I started to go on yoga retreats, um, started working with some really interesting teachers, and one of my teachers was a guy named Rodney Yee, who some of your listeners probably know, and Rodney's still out there teaching on the on the East Coast, uh no longer on the West Coast. But anyway, I was on a retreat one day and he he knew of my work in medicine because I'd been on retreats with him, and his one of his kids got sick once when we weren't on a trip, and I kind of helped out a little bit with that. Anyway, one day we were on a retreat taking a walk, and he he's like, Have you ever thought about this yoga thing? I go, What yoga thing? He goes, Teaching yoga. I'm like, what are you talking about? He goes, Have you ever thought about doing this? And I and I honestly, I don't think I had any conscious thought of that. At that moment, so he planted a seed that germinated over a couple of months, and this was in 1999. And later that year, my partner at the time was also very interested in studying with Rodney at his school in the West Coast. So, you know, made made a decision to see if it was possible to, you know, at least put a hold on my professional work as a family doctor and come out to California to study. And fortunately, the stars aligned, as they say, you know, as as certain uh doors closed, others opened very nicely. And uh I really felt kind of invited by kind of the flow of things to make this move. It felt it felt right. There was no resistance. Uh, places where I thought I would have difficulty, uh, you know, having conversations with my partners and things like that actually went surprisingly well. And in fact, some of them were kind of envious that I was making a professional change. They were also probably experiencing some of the burnout I mentioned. And uh, and so that's how how I found myself in Oakland, California, where I've been for the last 26 years. Mind-blowing. Um, and that led me to a variety of things that I've done now with yoga and integrating my past training in medicine for sure.

SPEAKER_01 8:36

Yeah, that's such a cool story. I did not know um that Rodney Yu was so influential in that. That's really that's so great. Yeah. Are you still in contact with him?

SPEAKER_00 8:47

You know, we were on a podcast, interestingly, we were invited to do a podcast with this guy from um from London, who's an Ashtangi who has a I'm trying, I think his podcast is called Keen on Yoga. His last name is Keen K-E-E-N. Okay. We were doing this panel thing with Richard Rosen, who's another big name in the world of yoga, uh, a writer of many interesting books and a friend of mine. So anyway, Rodney and I were on the call together, and so we caught up for a few minutes, but I haven't I haven't seen him for a while. And it was nice to he his energy was great and he seems to be doing really well. Oh, that's awesome.

SPEAKER_01 9:19

Great. Well, thanks for sharing that. Yeah. And so you've spent years advocating for healthy aging, kind of long before it became so popular as it is right now. So I'm kind of recognizing you were at the forefront of that. You know, currently the conversation now is shifted toward health span. I said lifespan earlier. Health span is really not just how long we live, but how well, and that's what you're really promoting. And you often talk about the big three physical benefits strength, flexibility, and balance. And so what tell us why these are non-negotiables as we age and how does yoga therapy address them differently from a standard gym workout?

SPEAKER_00 10:04

Oh, that's a great question. And I just want to mention that when my book came out, uh, co-authored with Nina Zolotov back in 2016, I think was our release date. So it's been 10 years. Yeah. Our primary pillar of yoga, we had three pillars for yoga for healthy aging that kind of evolved as we were writing about this and thinking about this um topic. And the first one is called compressed morbidity, which is actually expanding health span. So even 10 years ago, we were already clearly identifying that this idea of improving the length of time in which you have a quality of life that's what you want it to be was super important. And, you know, looking at the tools of modern yoga and the focus on asana, uh, we identified not just the three you mentioned, but kind of mixed in with balance, we also talk about agility. So we talk about strength, flexibility, balance, and agility as kind of the four essential physical skills that we want to maintain. One of the realities of aging is that depending on our level of activity in daily life, uh, we may encounter a gradual decrease in strength, a gradual limitation in flexibility. And as I hear over and over again, even with people that when I first meet them and they come in the door, I wouldn't say, oh, this person's gonna have trouble with their balance. People coming in saying, I'm noticing that my balance is getting worse over time, right? So, and they don't really identify agility so much, but the times that I think the lack of balance shows itself is when they're trying to maneuver in a challenging situation and they start to lose their balance. They get that their footing goes off, they catch their toe on something when they're walking out in their environment, uh, in their neighborhoods and stuff. And I think that's where they identify, oh my God, my my balance isn't so great. Now, it might show up in the yoga classroom, obviously, if we're doing lots of yoga poses. But I think a lot of these folks are noticing, you know, I'm having some close calls. And if you combine those losses on a more global way, look at the whole person having trouble with strength and flexibility and balance, they often impact one another. So a loss of muscle strength can then impact flexibility and balance, right? So they don't live in isolation, even though we talk about them as separate things, and we can address them somewhat differently in how we approach our yoga therapy uh protocols and the things that we share with the individuals that we work with. There's a situation that scientists call skeletal muscle atrophy. So all of our listeners at home should repeat that one more time. Skeletal muscle atrophy. Uh, and and when you talk to researchers in the lab, people who study aging, they will say things like, this is a natural process of aging. And yet, and yet you can slow it down. I don't know that you can stop it entirely, but you can definitely slow the process down. So it is modifiable. And we're going to talk about probably some other things in a little while that are modifiable based on what we choose to do. And so I think the great thing about yoga therapy and yoga in general as well, is that a regular practice of modern yoga asana works very nicely to help maintain and in many cases improve all four of those essential physical skills, right? So, I mean, it's it's elegant in its simplicity when we think about it. And yes, there might be some blind spots. For instance, I now integrate the use of therabands into my practice very regularly. My regular classes and my therapeutic work, when I work with individuals and yoga therapy, I'm using them in yoga poses, but I especially for upper body, I'm adding in upper body strengthening that I wouldn't get if I was just using the weight of my arms out to the sides, right? If I'm holding a pose that involves resistance against gravity. So I can I can use, I can integrate some modern tools using our more traditional yoga practice, and then I get to upregulate uh something that I want to do for my client that maybe they need more of, like strengthening, for example. So that's a little bit about that. Is anything else come up for you as I'm talking about that?

SPEAKER_01 14:09

Well, I think it's great. I can totally relate. I've been doing the same using uh light weights specifically in a yoga practice. And the thing that comes up for me when you share that, and and I know we're gonna talk more about other things in a little bit here, but we are just talking about asana, right? And and so you were very careful to say that several times, you know, modern yoga and asana for this health span. And we know that yoga is so much bigger than that, but even just with the yoga asana, we can do so much. And I think the question had to do with how is that different than a gym workout?

SPEAKER_00 14:53

Yes. Okay. So and I'm glad you brought that back because immediately another idea was in my mind, and then I let that go because I got caught up in that in the specifics. But the thing that is uniquely different is the quality of mindset that we bring to yoga therapy and to yoga in general. The mindfulness that we bring, even to the physical practices, right? So we can also, and I think it I think that um it's useful to know that, for instance, working on meditation and improving one's ability to concentrate and focus as a benefit of meditation, a side effect or a beneficial side effect of meditation, can be helpful when we think about agility and balance in our everyday lives. So, you know, so there's the mindfulness that comes from being mindful in practice, where we're really tuning in to the moment-by-moment feedback of how the body's feeling, where we're feeling it, what's going on. Is this a sense of weakness? Is this a sense of tightness? All those subtle things that we can start to tune into to get our get to know ourselves better. So then we can really focus more accurately on the places where we need to focus and let go of other places that seem to be fine. I think the mindfulness quality is one of the key things that I think about that really differentiates yoga from a typical gym practice where people are often doing a lot of things. They're listening to a podcast like this, they're watching CNN or whatever it is on the big screen in the in the gym. Uh, they've got someone they're working out with who's kind of yelling commands at them and not not in a mindful way, but in a commanding way. So, you know, it's just the whole milieu is different and the whole invitation is different.

SPEAKER_01 16:33

Yeah, and that again is just scratching the surface, but it's huge.

SPEAKER_00 16:37

Yeah.

SPEAKER_01 16:37

Yeah. So um you are focusing on some new work, a workshop series regarding flexibility and longevity. And maybe that's not super new for you, but it's in my awareness right now. So we often hear that flexibility is just for the mat, but you link it directly to a longer, more resilient life. So, can you walk us through the medical connection between maintaining mobility in our tissues and our actual longevity markers? I love to bring in any kind of scientific, Western medicine that substantiates what we know is happening or what we think is happening in yoga.

SPEAKER_00 17:20

Great. I was excited because there was a relatively new study that came out just a year or two ago. And it wasn't a yoga-related study. It was a study on flexibility and longevity. And again, keeping in mind they're looking at lifespan, not necessarily health span. But I think the corollary here is that typically when people maintain something like good flexibility, it also benefits their health span, right? The quality of their day-to-day life is improved. They're able to feel more comfortable doing everyday activities and special things that they love to do, right? That they wouldn't do otherwise. And so the study looked at, it was done by a Brazilian group of researchers. They looked at like over 3,000 uh people that they uh included in the study. They developed an evaluation of flexibility that they called the flexa test, and it involved uh multiple joints uh looking at multiple movements. And so people that entered the study were put through the flexa test and given a rating. And a high rating meant you had really good flexibility, a low rating meant you did not have very good flexibility. And the study started in the early 90s and concluded in like 2023. So they mean they they followed people over a long time, and the tip average amount of time that they would do a check-in was about 13 or 14 years after the initial evaluation. So they evaluated their flexibility at the beginning of the study, and then the question was were they alive when they checked in with them 14 years later? They were curious, were these people more likely to still be alive? So did flexibility impact mortality rate over time? Okay. And that what they found that is indeed it did. Now, this was a correlation, it doesn't mean causation. So they were very clear in saying, hey, you know what? This is just this is great information. We're excited. No one has ever looked at this question before. So they were the first people to look at this specific idea around flexibility. We know that flexibility, uh, maintaining flexibility can reduce pain, for example. There are uh there are other physical benefits that have been studied before, but this particular aspect hadn't been looked at. Um, so that was exciting. And um, they also didn't go into like what was the individual doing when they did the flexa test? Were they yoga practitioners? Did they do Tai Chi? Were they run? I mean, they didn't ask those kind of questions, but they realized that they wanted to, in future studies, really get clearer on what were people doing that might have contributed to their level of flexibility. Did some of these people have a genetic inherited condition, like Aylor Danlow syndrome, that conferred greater flexibility on them? So, I mean, there were a lot of things that they didn't get a chance to go into, but the results were significant. And what they noticed is that a person with a low flex index score versus someone with a high score. So if you had a very low score, if you were a woman, you were almost five times more likely to have died in that interim space.

SPEAKER_01 20:20

Wow.

SPEAKER_00 20:21

Huge, right? If you were a man with a low flex index score compared to a man with a high score, it doubled your chances of dying. So it was actually more impactful for women than men, which is interesting. Yeah. Um, even though women uh typically had better flexibility overall than men. But the loss of flexibility, the the inflexibility seemed to have a bigger impact on mortality rates. Again, they didn't know why for sure, but again, it's another question to look at down the road. So, you know, when I look at that through my yoga and yoga therapy lens, I say, you know what, this is supportive, encouraging evidence that maintaining flexibility, and they didn't look at, they didn't retest people for their flexibility at the end of the study. So we don't know if those people maintain their initial level of flexibility. We just we don't know that. But they were flexible at the beginning, and and and then they've looked at mortality rates. So, you know, my feeling is that for people practicing yoga regularly, we might even have a greater benefit, not only on longevity, but on health span as well, improving our health span over time. Um, and so time will tell, research will hopefully support some of those assertions, but it gives me more motivation. I can use that to motivate myself and hopefully to motivate my clients and my patients who are looking for, you know, sometimes they want more reasons. Why should I bother with this? Oh, here's a study that says if you maintain if you're f if you have good flexibility, you're more likely to be around 14 years from now. Um, so so kind of interesting stuff. That's the most recent study that that kind of got me excited, and that led uh me to do like a I did a uh A three part or a four-part series on flexibility through a local uh yoga studio that I do a healthy living series for.

SPEAKER_01 22:07

I love that. That's great. So let's talk beyond the physical. Okay. Because that's of course important too. And you place a huge emphasis specifically on equanimity. Yes. And you've called it a powerful antidote to uncertainty. And I love that. Um and so for a person coming to yoga therapy dealing with a frightening diagnosis or the inevitable changes of aging, which maybe aren't so inevitable, but how does the practice of equanimity transition from a mental concept to a physiological felt sense? And maybe even level set, what you mean by equanimity. It's a word that gets tossed around in yoga circles a lot, but sometimes when I bring it in, people ask me what does equanimity mean?

SPEAKER_00 22:54

Oh yeah.

SPEAKER_01 22:55

It's not in the common language as much.

SPEAKER_00 22:58

Exactly. And if I'm talking with folks, I often ask them to define it for me. And I realize, well, they're all kind of all over the place. And you know, in in our um in our X when we were doing yoga for healthy aging as a blog before the book came out.

SPEAKER_01 23:13

Yeah, I remember that.

SPEAKER_00 23:14

Yeah, uh, a lot of folks would write in with questions that that really dealt with this topic. They were like, hey, I just found out I have Parkinson's, and you know, I'm I'm my my symptoms are really mild, but I'm kind of freaked out. I'm scared about the future. I just don't know what to do about this. And so really they were confronted with an existential crisis, right? Suddenly their life had been one thing one day, and after a doctor's visit, it had completely changed. And they were moving into this this kind of area of scary uncertainty. And so looking back uh at some of the kind of foundational ideas around yoga, I mean, even going back to the Bhagavad Gita, where you know, Krishna and Arjuna are having this conversation, and Krishna's, I mean, sorry, Arjuna's freaked out. He's like, oh my God, my my uncle's over there on the other enemy line, and I got, I'm supposed to go kill that guy. Are you kidding me? He doesn't know what to do. There's this uncertainty. What am I supposed to do? And uh Krishna says, you know, that that yoga is equanimity. It's this sense of groundedness and calm, peacefulness, even in the face of uncertainty, right? So equanimity is an internal state of being that doesn't deny the stressor that we might be encountering. It doesn't deny it, it doesn't push it away, it doesn't draw it in. It just says, okay, this is happening, and I'm gonna drop into this place, this, like you said, a felt sense of groundedness, of inner calm that really connects me with probably my deepest values, whatever that is for me, right? Uh, you know, one of the things I try to remind myself every day is, you know, how can I be of service today? Right. So, you know, if I'm confronted with something like that, it's like, how do I see that through my lens of service? You know, that might be what a question I might ask myself as a way of connecting with the feeling of equanimity. And practices like a daily meditation practice, which I've, you know, I feel grateful that in the last year or so I've been much more uh diligent about doing a daily meditation practice when I get up in the morning. Um, I think those kinds of practices are incredibly powerful in helping to find that felt sense of equanimity, of inner calm and peacefulness in the face of even like even exciting things that get you jazzed up, like, oh, there's a wedding, I'm so excited to go to it. Yeah, but I could get overly excited with that. You know, so it's not always the things we think as negative, even things we're kind of excited about can kind of throw our sense of internal homeostasis and balance off. And so I think that's that's what I'm usually looking for when I think about equanimity.

SPEAKER_01 25:52

That's great. Thank you. And I appreciate you making some uh context around that too, in terms of what does that mean and how can we practically employ it each day? Yeah. Because that's what it comes down to, right?

SPEAKER_00 26:08

Right. And so, you know, our clients, I mean, they may be coming to you from back pain. Like I see a lot of people with physical pain issues that come to me for yoga therapy. My question is often like, well, how's that really impacting your the things you love to do? I mean, are you able to still participate in, you know, your uh extra activities and how are your daily life stuff that you got to do around the house going? And, you know, what about how's it impacting your relationship? So, you know, again, we're, you know, as yoga therapists, you know, we're interested in the whole person and how, not just the back, right? We want to say, well, you're a human being who has some back pain right now. How are you as a human being? You know, so I'm always kind of curious about that. And so that's where I usually tease out whether or not they're feeling grounded or whether they're really in that place of uncertainty where they're struggling to find some tools that are gonna help them get back into a in a clearer place so they can see their path a little more easily.

SPEAKER_01 27:01

That's great. So let's talk uh specifically about the brain and Alzheimer's. So you've been looking at research on yoga and Alzheimer's prevention, and there's a substantial amount, as far as I know. Um I'm I'm aware of some anyway, that comes more from Kundalini yoga. Um so for those of us in midlife looking at our future, or just really for anyone, what are the most important neuroprotective elements of a yoga therapy practice that we should be doing right now?

SPEAKER_00 27:38

Well, the good news is that all kind of all of our basic uh yoga practices are neuroprotective in some very nice ways. And I will I'll I'll tease that out in a moment. So I'm talking, and when you look at the research that's been done looking at yoga practices and how they impact some of these different factors that I'll uh share with you in a moment, um, the the research almost always includes asana, pranayama, and meditation. It might also include bhakti practices or you know, some sort of chanting practice. Um, and so there, and there might be some karma pra karma yoga practices as well. But the big three that I just mentioned are almost in all of the research papers. Those are the tools that are used most regularly. So the good news is, you know, if you're doing a lot of asana but you're not doing much pranayama and meditation, you can think about putting more emphasis on the other two tools so that you're getting the the most well-rounded global practice you can do for neuroprotection, right? So that's what I usually encourage people to look at. What are you doing a lot of already? You don't have to change that, but how can you invite some of these other things into your practice?

SPEAKER_01 28:46

Yeah, just layer them on, right?

SPEAKER_00 28:48

Yeah, and we know, for instance, that some of these practices have been shown now to affect the um uh the ends of the DNA strands uh that can some that are are we're starting to understand more about how they're related to longevity and also good cognitive function. Um, but that's kind of one little scientific snippet that's out there. But let me talk just real briefly, just to give people a little background on the main risk factors for developing Alzheimer's or dementia, right? So the big three are uh advancing age, which so far we can't do anything about. We're you know, I'm older today than I was yesterday. Uh genetics. This is very important. So the um APOE E4 gene that people can inherit from their family uh can increase your risk from threefold to twelvefold if you have one or two copies of that. So that's something that if you have a family history of Alzheimer's, you can go get genetic testing on. In fact, a local um yogi and Ayurvedic uh specialist and acupuncturist in my area uh found does have a family history of that. He got tested. He now knows what his risk factor is because he does carry at least one of those. And he's really now retooled his whole personal practice to focus on neuroprotection. Right? So that's something you can, that's information you can get if you're willing to go there. And I know it's scary for people, that's an area of uncertainty, but you know, it might be better to know where you stand to know how much energy you want to put into the neuroprotective uh practices. Um, and then family history. So age, genetics, and family history are the big three. Okay. Those are the big three.

SPEAKER_01 30:31

Differentiate family history from genetics.

SPEAKER_00 30:34

Yeah, so there might be a history of uh a family history of forms of dementia, but no one's ever been tested for the genes, right? So again, it would just be something to keep in mind. Uh but I I know people now who say, oh yeah, we we have that gene in our family tree. So they know that also. The other thing is inflammation, background inflammation, which we know impacts almost all diseases of aging. Seems to be an underlying factor for that. The development of metabolic syndrome, which is this weird, interesting thing where you have pre-diabetes, pre-hypertension, high cholesterol numbers, and fat gain around the midsection of your belly area, right? So if you have a combination of any three of those five different factors, you are said to have metabolic syndrome, which doubles your chances of developing heart disease and diabetes over the next five years, right? So, but it also increases your chance of having dementia as as a as as you get older as well. Um, and then finally, low cardiovascular fitness. So all of these things are generally considered some of the risk factors to keep in mind when we're looking at it. Now, there was a great paper that came out, uh, I think it was a Lancet White paper, 2022, something like that, that identified eight modifiable risk factors for dementia. Modifiable, meaning we can do something about that. And modifiable usually means lifestyle changes. And yoga practices are lifestyle changes. So bingo, lights go off in my mind whenever I see something like that. And these include um smoking, or right, if people are smokers, if they have type 2 diabetes, suffering from depression, uh, have developed high blood pressure, alcohol or substance abuse, traumatic brain injury, interestingly, and hearing loss. This one was very interesting. Development of hearing loss connected. There was a study done in England in 2023 that made a connection between hearing loss and the development of dementia. Um, and then low education level, like you never got past high school or didn't get your GED. Um, interesting, right? So these are modifiable risk factors, right? Because we can encourage people to go back to school and get additional education. Um, and we can you know work with people who have hearing loss to improve their hearing. And we can, right, these are right, so they're modifiable. Now, I was looking at this through my lens of yoga and yoga therapy. What do we know from other research that's been done on yoga and these different modifiable risk factors? Well, we know that we can help people with smoking cessation, alcohol, and substance abuse issues. We know that we can have significant impacts on type 2 diabetes and perhaps getting people back to a non-diabetic state through a combination of different yoga approaches. We know that uh mental illness, depression, and anxiety are we can, in combination with Western practices, do a really good job at resolving people's depression or improving it dramatically. We know from studies that have been out for now 30, 40 years that yoga and yoga therapy impacts high blood pressure and cardiovascular risk. Um, and so we also have a lot of people now working in yoga therapy around traumatic brain injury. And I think we're gonna get more data on that as time goes on. So I'm encouraged by the trend in yoga and yoga therapy to address that particular issue. And then, although I don't know if we specifically address it in the settings of someone who has lower education, but I know a lot of people get excited by yoga and decide to go into yoga training, which is a form of education. So I think in some level, we could say it even impacts that. So when we address these modifiable risk factors, what is the impact on one's chances of getting dementia down the road? Well, it decreases by up to 40%. We reduce the risk by 40%. Not bad, right? I mean, it's and in fact, if you look, if you think about the impact of modern medications on the course of people who already have dementia, the reduction of 40% is much more effective than those medications are, right? They're expensive, they have side effects, you know, they're all we have right now. I mean, there's a lot of research going on into that realm of medicine. But right now, this is pretty encouraging that we can have, we could almost half reduce our risk by half by using our tools to address these specific issues. So in your own life, if you're a listener right now, you say, well, do I have any of those things on my list? And can I address those things through yoga therapy? I would also mention that yoga therapy probably addresses underlying inflammation. We know that from studies looking at brain health, where they were able to show a decrease in inflammatory markers like interleukin 6 in the brain and people that were doing meditation and yoga practices. Um, we also know that um yoga can be a powerful tool in reversing metabolic syndrome because, as I mentioned, pre-hypertension, pre-diabetes, yoga does a pretty good job with that. Can it impact cholesterol levels? It can to a certain extent. If people have an inherited propensity for high cholesterol, it doesn't work so well there. I can speak from experience. I have a family history of that, and both myself and my brother and yoga did not get my numbers down where they needed to be. So I need to do, I need to use some Western medical stuff that's very effective and has a low side effect profile. And so I can continue doing my yoga and my Western medicine to lower my risk factor of dementia as it relates to those risk factors. And then low cardiovascular fitness. Of course, if we get people moving again, we improve their cardiovascular fitness. So the eight modifiable risk factors and some of the other risk factors I talked about are totally addressable using our yoga tools. And therefore, we can use our yoga therapy practices to impact our cognitive function and lower our chances of developing dementia down the road.

SPEAKER_01 36:40

That's so cool. Thanks for sharing all that and so clearly, yeah.

SPEAKER_00 36:44

Yeah. Now, does that mean you're not that you couldn't one day wake up and have stage one dementia? Absolutely not. There's no guarantees, right? We're we're talking about totally what I'm thinking about in the in the lens of health span is if I can reduce the um even the amount of time I might before I develop something like that, then I'm increasing my health span. So even if inevitably this is what takes me down, or at least I have to deal with, you know, 10, 15 years from now, I might be able to postpone that by doing everything I'm doing now. Yeah, yeah, that's great.

SPEAKER_01 37:21

So looking at where we are currently, do you see the medical community finally catching up to the value of yoga interventions? Um you were talking to a younger version of yourself, how would you encourage them to bridge these two worlds? What do you see from your perspective?

SPEAKER_00 37:38

Well, the answer is yes and no. You know, I'm very encouraged, you know, when I'm working up a new topic that I'm going to be talking about for an upcoming workshop or retreat or whatever, and I go online to do a search and I go to the Cleveland Clinic um website and I'm reading about, you know, their recommendations for people with connective tissue disorders. And, you know, in their recommendations is lifestyle modification using such tools as yoga. I'm ecstatic, right? So, and I know that Cleveland Clinic has yoga therapists on staff in some of their departments. So I know that there is some areas in which the medical system is embracing that. And usually these are centers that are involved in research. That's right. Whereas, you know, the the hospital that I used to admit patients to in the Cincinnati area, I know they don't have a yoga therapist on staff. Could they benefit from that? They certainly could. If they looked at uh things like um uh uh stroke rehab, if they brought a yoga therapist into their team, that could complement the feet the PTs and the other folks, the OTs that are giving really great advice and practical practices for people recovering from those conditions, but there's stuff still missing, right? That I think that yoga therapy could add into that. So I think we're doing well. There's still, we still see a decent amount of new research coming out each year, some of it specifically you using yoga tools, others that are kind of adjacent to our yoga practices that I think are again waking up the medical community to the benefits, this kind of practice. And so I'm encouraged and I also wish things would move quicker.

SPEAKER_01 39:17

I would also say what I'm noticing is this recognition of whole person health more and more frequently through even governmental uh entities today, for better or worse, right? But yoga is whole person health. But I don't know that Western medicine or the ones who are advocating for whole person health see yoga in that picture either.

SPEAKER_00 39:44

So yeah, again, I think it's happening, it's not happening as quickly as I would like. And there are certain uh hot spots where people are forming integrated primary care groups and using yoga therapists as part of their team approach and uh and having an OBGYN in the office and uh a massage therapist. And you know, so that's very exciting when when we when I see those things. And I've and I visited uh a place in the D uh Washington, D.C. area that was doing that a number of years ago. But again, I I think we still don't have models of reimbursement, right? And which are important for sustainability, right? You have to be able to sustain the practice so people are making a living wage and and have a quality of life that are the practitioners and don't get burnt out, right? So that whole thing of professional balance where I was burnt out, yeah, had I had programs in place that introduced me to yoga therapy or even yoga practices for my own health at that time with that focus. You know, maybe I would still be doing primary care. I don't know. And I, you know, I can't go back in time and change that. But there are some medical school training programs. I know Kaiser was developing one that was going to open up down in Southern California. It was gonna be a medical school down there, and they were integrating a requirement that all students had to go through an eight-week yoga practice as part of their training to expand their understanding of alternative modalities that they could utilize when they're recommending their patients to get different types of practices they they could do to support their health. So I was super jazzed about that. Yeah, that was happening. And I don't know where the status of that is right now, but that was about two, three years ago. And I'm hoping it is still in evolution, it's gonna be a reality.

SPEAKER_01 41:23

Very cool.

SPEAKER_00 41:24

Yeah.

SPEAKER_01 41:25

I'm sure we could talk a lot more about that. But um I'd love to just kind of wrap up by thanking you for all the work that you've done for these decades now. And um maybe you can just give some insight. I always like to ask this at the end. Talk to us about your daily practice because we know that it's so important not only to be teaching this stuff, but first of all to be embodying and practicing this stuff for ourselves. And that's where we're able to teach from. And I know for myself, my practice certainly has evolved through the years, and I'm sure yours has as well. So tell us just like what does your daily practice look like today?

SPEAKER_00 42:03

Yeah. Well, I I did my daily practice. My my daily practice is usually my meditation practice.

SPEAKER_01 42:08

Yeah.

SPEAKER_00 42:09

And the main reason is since the pandemic, I teach almost every day of the week. And because I'm teaching hybrid classes, my folks at home have to not only hear what I'm saying, they need to have something to look at. So that's me. So I actually do a lot more asana practice now than I ever did before the pandemic. So I do an hour to an hour and 15 minutes of physical practice every single day, except maybe Sunday and some Saturdays when I'm not teaching a workshop. So I have a regular physical practice because I do it when I teach. Now, that obviously has a different quality than when I do some asana on my own. And I and I do that on occasion for sure. But I meditate every day. And I get up in the morning, I set my timer, I got my intention, and that's really what grounds me. I find that, you know, number one, it's what feeds my sense of equanimity and it gives me a clarity on what I'm doing today and what I'm doing this week and what I'm doing this month, and you know, where I want to be putting my energy. I also do, I mess around with pranayama during the day, just whenever I think of it. Um, and so that's kind of just like a little, it's like a little appetizer I do for myself periodically, but that's that's the state of my practice these days.

SPEAKER_01 43:21

That's great. Yeah. Well, thanks again. It was great to reconnect with you. Maybe I'll see you at the yoga therapy conference in June, and uh I look forward to staying in touch.

SPEAKER_00 43:33

Thanks, Michelle. So great to see you again.

SPEAKER_01 43:40

Thanks again for listening. If you're interested to learn more about who we are and what we do, check us out at inner peaceyogatherapy.com.