Researchers say the finding highlights the need for more evidence and better conversations about risks and benefits of mindfulness, yoga, tai chi, acupuncture, and other complementary health approaches
A new study by investigators from Mass General Brigham suggests that complementary health approaches (CHA)—including massage, yoga, tai chi, herbal products, acupuncture, spiritual practices, cannabis and psychedelics—are now a routine part of health and wellness for many older adults, even though they are not always discussed with healthcare providers. Using survey data from participants in the COSMOS trial, researchers found that 58% of older adults had used complementary health approaches in the last year and more than 75% had used one or more CHA in their lifetime. Their results are published in the American Journal of Medicine.
"Before this study, we did not know much about the characteristics of older adults who are using these complementary therapies," said lead author Dennis Muñoz-Vergara, DVM, MPH , a researcher in the Osher Center for Integrative Health at Mass General Brigham. "This is one of the largest studies of complementary therapy use in older adults."
The study surveyed 16,144 participants (women over the age of 65 and men over 60) in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), a large randomized, double-blind, placebo-controlled clinical trial of cocoa extract supplements and multivitamins. It's important to note that the study group was not a perfect snapshot of older adults in the United States since participants were enrolled in a randomized clinical trial testing two dietary supplements. They were likely healthier, more engaged in health issues and had higher socioeconomic status than the broader population.
The survey focused on six categories of complementary therapies — manual therapies, such as chiropractic care; mind-body therapies, such as tai chi; herbal products; acupuncture; spiritual practices; and the use of cannabis or psychedelics. Participants were asked whether they had ever used these therapies and then if they had used them in the past 12 months. The study did not ask why people used these therapies, how often they used them, the intensity of use, or their efficacy.
Complementary therapy use was common in this group: 58.8 percent of respondents said they had used at least one in the past 12 months, and 76.4 percent said they had used at least one in their lives.
"What surprised me most was just how common these complementary therapies were," said Muñoz-Vergara, who was the first and corresponding author on the paper. "They are much more mainstream than many people may realize."
Spiritual practices were the most commonly reported approach in the past year at 38.6%, followed by manual therapies at 20.8% and herbal products at 20.5%. Acupuncture was the least commonly used at 3.7%.
Beyond overall use, the study found that women were more likely to report complementary therapy use. Additionally, use was more common in people with more education, higher physical activity, a history of falls, and a history of depression.
"There may be a disconnect between what patients are doing and what health care providers realize," said senior author Howard Sesso, ScD, MPH , Director of Nutrition and Supplements Research with the Osher Center. "Patients often seek to supplement their doctors' recommended treatments. I hope this study opens the eyes of the health care community to talk to their patients about complementary and integrative health modalities."
Authorship: In addition to Muñoz-Vergara, Mass General Brigham authors include Yan Ma, EunMee Yang, Sarah Jaehwa Park, Wren M. Burton, Eunjung Kim, JoAnn E. Manson, Gloria Y. Yeh, Peter M. Wayne, and Howard D. Sesso.
Disclosures: Sesso reported receiving grants from the NIH during the conduct of the study and from Mars Edge and Haleon outside the submitted work. Manson reported receiving grants from the NIH during the conduct of the study and from Mars Edge outside the submitted work. Wayne and Yeh reported receiving grants from the National Center for Complementary and Integrative Health (NCCIH) during the conduct of the study. No other disclosures were reported.
Funding: This study was supported with grants from the National Institutes of Health (NIH) (1K01AT012889, 1K23AT012475, 5T32AT000051, 1T90NS138001-01, K24AT009282, and K24AT009465. The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is supported by an investigator-initiated grant from Mars Edge, a segment of Mars Incorporated dedicated to nutrition research and products, which included infrastructure support and the donation of study pills and packaging. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging. COSMOS is also supported in part by NIH grants AG050657, AG071611, EY025623, and HL157665 and contracts 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, and 75N92021D00005 through the Women's Health Initiative at the NIH.
Paper cited: Muñoz-Vergara D et al. "Use of Complementary Health Approaches and Research Interests Among Older Adults in the COSMOS Trial" American Journal of Medicine DOI: xxx
