Sauna for frailty in older adults
Evidence review
Overview
In a Japanese before-after study of 67 community-dwelling older adults (41 pre-frail, 26 frail), a far-infrared low-temperature sauna program twice a week for 3 months was followed by improvements in walking speed, peak oxygen uptake, depression score, health-related quality of life and several geriatric symptoms. The frailty score improved in 18 participants, was unchanged in 47 and worsened in 2. There was no control group.
Key findings
- Frailty score (J-CHS) improved in 18 of 67, unchanged in 47, worse in 2 after 3 months (Sugie 2020)
- Significant changes in usual walking speed, peak oxygen uptake, GDS-15 and health-related quality of life (Sugie 2020)
Every study we reviewed
1 found benefit
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 2 studies on frailty, across all heat and cold therapies, including case reports and older work not graded here.
Effectiveness of a far-infrared low-temperature sauna program on geriatric syndrome and frailty in community-dwelling older people.
Sugie M et al. Geriatr Gerontol Int. 2020. PubMed 32776407 · DOI · Free full text
- Who
- community-dwelling older adults, mean age 79.6, 41 pre-frail and 26 frail (J-CHS criteria)
- What
- far-infrared low-temperature sauna program
- Protocol
- 2/wk · 13 wk
- Measured
- J-CHS frailty score, walking speed, peak oxygen uptake, GDS-15, health-related quality of life, geriatric symptom ratings
- Result
- Significant differences in usual walking speed, peak oxygen uptake, GDS-15, quality of life and several geriatric symptoms; J-CHS score improved in 18, unchanged in 47, worse in 2; change in cold extremities (B=-0.105, P=0.013) and cumulative geriatric symptom rating (B=0.044, P<0.001) independently predicted frailty-score change.
- Limitations
- uncontrolled before-after; no blinding; Japanese volunteers; 3 months only
Protocols used in the studies
Far-infrared low-temperature sauna twice a week for 3 months; temperature and session length are not stated in the abstract.
What is still unknown
Randomized trials against exercise or usual care; durability after the program; falls and hospitalization outcomes; safety in the frailest patients.
Safety
Cautions for sauna in this condition
- Frail older adults are at higher risk of orthostatic hypotension, dehydration and falls with heat exposure; the abstract does not report adverse events (PMID 32776407).
- See general-safety.
For clinicians
Suggested rationale
In an uncontrolled study of 67 pre-frail and frail older adults (Sugie 2020), a twice-weekly far-infrared low-temperature sauna program for 3 months was followed by improved walking speed, aerobic capacity, mood and frailty scores in some participants; no randomized trial has confirmed this.
Suggested wording only. The treating clinician decides whether it reflects their clinical judgment for this patient.
Typical ICD-10 codes: R54. Examples only; the clinician assigns the code.
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