SYKESVILLE — It was mid-morning on Friday, Oct. 14 at Integrace Copper Ridge residential community for people with Alzheimer's disease, and about a dozen people sat in their chairs, eyes closed, listening to the soft and soulful voice of a folk singer.
"I am very passionate about Alzheimer's issues; my grandmother had Alzheimer's," said the singer, Sarah Ragsdale, who had driven the four hours and change from Pearisburg, Virginia, to play at a two-day yoga seminar at Copper Ridge at the behest of Dr. Nicole Absar, the medical director of the Copper Ridge memory clinic.
"I love the work that Dr. Absar does."
If two days of yoga and folk music doesn't sound like standard care for Alzheimer's disease or other cognitive disorders, then that is exactly the point of Absar's seminar; "Introduction to Brain Disorders and Yoga" was designed to introduce health care practitioners to a more complementary approach to treating dementia and other conditions.
"Most of the participants are health care providers and yoga teachers, and also physical therapists, they try to incorporate yoga into their therapy," Absar said. "How neurology and yoga blend together, that's what I am trying to show."
Absar is a trained neurologist, psychiatrist and a yoga teacher, the latter credential being one she came to late in her career.
"When I went to neurology training, I thought I knew everything. I knew all about the structure of the brain. But I was wrong, because I didn't know the mental faculty, the mind, so my life was really dry," Absar said.
"I went back to psychiatry residency. Now, I thought I knew everything because I had the structure, I had the function. I was wrong again because I didn't have the connection between the mind and the brain, which is the soul, which is the spiritual aspect. That inspired me to go into mindfulness and yoga training."
While there are no treatments that can halt or reverse the progression of Alzheimer's, according to Absar, there are things that can be done to mitigate discomfort and improve the quality of life of those living with it, as well as other cognitive disorders. She points to research out of Boston University that has shown that regular yoga can be effective at raising levels of the neurotransmitter GABA in the brain, a chemical that promotes calm and reduces anxiety — it's the target of anti-anxiety drugs such as Valium or Ativan.
Absar experienced the power of yoga to mimic the calming effects of medication first hand while practicing in Boston prior to her coming to Copper Ridge. A patient who had suffered a stroke in a part of her brain known as the thalamus was experience an extreme anxiety attack, a common experience for thalamic stroke patients, according to Absar, and was running the attending nurse ragged.
"My nurse was asking if she could get an order for Ativan, which is what we use for anxiety," Absar said. "Instead of writing the order got Ativan, I asked the patient to hold my hand and led her to a room that we named the serenity room. I had her sit in front of me and I started doing a breathing exercise called alternate nostril breathing, which is very effective for anxiety."
After five minutes of this yogic, alternate nostril breathing, Absar said, and the patient was so much more relaxed that the nurse was shocked at the change in her affect.
"I didn't cure her disease —she has a thalamic stroke, that's not curable — but what I did do is not bad, I avoided one dose of Ativan," Absar said. "Ativan is toxic for your memory, it can cause further worsening of dementia, so we try to not give Ativan to our elderly."
That's not to say that medication is never warranted, Absar said. The beauty of yoga as a therapy, she said, is that it is not all or nothing, but can complement existing therapies.
That was part of the big takeaway from the seminar for Beth Reigart, a clinical operations specialist with Functional Pathways, which contracts with Integrace to provide physical therapy services. She had come up from her home in Charleston, South Carolina, for Absar's seminar.
"Dr. Absar, her background is so diverse with the integration of a scientific, neurological background and a very clinical focus, psychiatric background. That's typically seen as more Western medicine," Reigart said. "Then to bring more of the Eastern medicine in, meditation and the use of music and the application of yoga poses is, I think, just a phenomenal experience."
The techniques using music and breathing, not necessarily yoga "poses," will be useful in dealing with patients who have anxieties or conditions such as posttraumatic stress disorder, according to Reigart.
"A lot of our older residents have been in war, we may have had someone that was a POW, we may have had someone who had some kind of childhood trauma that would continue to be part of their being," she said. "Yoga can be used in terms of helping them move forward with their lives and trying to minimize the impact that has on their day-to-day activities."
And the more physical aspects of yoga have their complementary application in rehabilitating all kinds of patients, Reigart said, from those who have been in car accidents to those with Huntington's disease.
"A lot of the movements are bilateral, meaning that you are using both sides of the body," she said. "From a neuro-rehab standpoint, that's something we have learned in school, but to be able to do it in more of a flowing posture, and using that rhythm, I think we will see a lot of benefits that are trying out this new, innovative strategy."
The date for any future yoga seminars for providers has not yet been determined, according to Absar, but information will be posted on the Copper Ridge website at www.copperridge.org. In the meantime, she said, people in Carroll County can attend a free adaptive yoga class from 4:30 to 5:30 p.m. every Tuesday at Copper Ridge. It's for every ability level.
"Yoga can be modified according to the patient's body and patient's level of functioning," Absar said. "You can modify the posture. It should be fine for a 90-year-old, severely osteoarthritis patients in the same way as for an 18-year-old girl with really good flexibility. Everybody can do yoga."
If you go
What: Adaptive yoga classes
When: 4:30 to 5:30 p.m. Tuesdays
Where: Integrace Copper Ridge, 710 Obrecht Road, Sykesville
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Cost: Free, but call 410-552-3211 to reserve your spot in class.