Retinal neurovascular and mitochondrial function signatures related to cognition improvement following yoga exercise in older adults

PURPOSE: To investigate the associations between retinal neurovascular and mitochondrial function signatures and cognitive performances following a 24-week yoga intervention in healthy older adults. METHODS: Thirty healthy older adults (mean age 72 ± 6 years; 25 females) participated in three 60-minute sessions per week of either YogaCue or Hatha yoga over 24 weeks. Retinal structure and vessel density were measured using optical coherence tomography angiography (OCTA), while retinal blood flow (RBF) was assessed using Retinal Function Imager (RFI). Mitochondrial function was evaluated via macular flavoprotein fluorescence (FPF) using the OcuMet Beacon. Cognitive performance was assessed at baseline and follow-up using the NIH Toolbox, Trail Making Tests (TMT-A/B), and the Hopkins Verbal Learning Test (HVLT). RESULTS: Several nominally significant correlations were observed between changes in cognitive performance and changes in retinal measures. These included associations between changes in Flanker Test performance and both RBF (ρ = 0.49, p = 0.007) and retinal capillary function (ρ = 0.42, p = 0.03); between changes in Total Recall and retinal tissue perfusion (ρ = 0.39, p = 0.04) and capillary function (ρ = 0.41, p = 0.04); and between changes in List Sorting performance and optic nerve head FPF (ρ = -0.61, p = 0.003). However, none of these associations remained statistically significant after Benjamini-Hochberg false discovery rate correction. CONCLUSIONS: This pilot study identified exploratory associations between changes in retinal neurovascular and mitochondrial function and changes in cognitive performance following a yoga intervention in healthy older adults. Although these findings may suggest potential retinal signatures of cognitive change, they should be interpreted as hypothesis-generating and require validation in larger independent cohorts before definitive conclusions can be drawn.