Chanting Buddhist sutras may improve breathing and swallowing in older adults

A research team led by Senior Deputy Director Ayako Edahiro of the Research Team for Promoting Independence and Mental Health at the Tokyo Metropolitan Institute for Geriatrics and Gerontology, together with researchers from Taisho University, announced on June 10 that it had developed and implemented a health program incorporating Buddhist sutra chanting and observed preliminary improvements in mental well-being and in measures related to respiratory, phonatory, and swallowing functions. The findings suggest that culturally rooted practices may help support healthy aging. The results were published in Geriatrics & Gerontology International on May 27.

A Japanese study reported that aspiration pneumonia accounted for more than 70% of pneumonia cases among patients aged 70 years or older, which is also a major cause of death. Intervention programs for prevention are widely conducted. Programs that incorporate culturally familiar elements are often easier for older adults to embrace and maintain. Therefore, the team developed a health program using Buddhist sutra chanting practiced at temples and evaluated preliminary changes in mental well-being and in respiratory and swallowing-related functions among community-dwelling adults.

Targeting 44 local residents recruited through post office flyers and other media, a total of seven sessions of one hour per week were held at Zojoji Temple and Gokokuji Temple in Tokyo. Home practice was also recommended. For the sutra chanting program, the "Heart Sutra," which can be chanted in a relatively short time, was used. Participants were provided with large-print texts, phonetic reading guides, modern Japanese translations, and explanatory notes.

Participants were instructed to maintain proper posture, use their bodies as resonant instruments, take longer breaths, and articulate words clearly with wide mouth movements while chanting. At the beginning of each session, warm-up exercises focusing on breathing and oral functions were performed, incorporating upper-body relaxation to encourage deeper breathing, stretching, and movements effective for oral and swallowing functions. Furthermore, mini-lectures by instructor priests and group work were conducted at every session.

The average age of participants was 70.0 ± 9.1 years, and the attendance rate was 90.5%. As a result, the WHO-5 Well-Being Index increased from 15.6 ± 5.8 before the intervention to 18.4 ± 4.8 after the intervention. In the evaluation of swallowing-related function, the hyoid displacement during swallowing (ΔHD) significantly increased from 38.6 ± 6.8% to 52.9 ± 7.1%. As a measure related to respiratory and phonatory function, the maximum phonation time (MPT) significantly increased from 17.5 ± 6.3 seconds to 20.2 ± 6.8 seconds.

The findings suggest that incorporating sutra chanting into a community-based health program may have the potential to support mental well-being and respiratory and swallowing-related functions in older adults.

Moving forward, the team aims to explore how culturally meaningful practices such as sutra chanting can be incorporated into community health and social prescribing, while respecting differences in religious and cultural backgrounds.

Edahiro commented, "Various exercise and health programs are offered to help older adults maintain their physical and oral functions but sustaining participation can be challenging. Such programs may be less appealing to older adults who do not feel that they have problems with eating or swallowing. On the other hand, many older adults visit temples on their own initiative because they are interested in Buddhist teachings and philosophy. I believe the ideal form of health promotion is one in which people do something meaningful to them, and health benefits follow naturally. That idea inspired this research. Some temples are highly committed to serving their local communities and have shown great interest in the potential health benefits of the program. If we continuously carry out such initiatives targeting older adults, over time, some participants will become caregivers, while others may require care themselves, or face their own worries and suffering. Temples have long stood alongside people facing suffering, loss, and difficult questions in life. I hope they can once again become places where people gather, build relationships, and find support within their communities."

Journal Information
Publication: Geriatrics & Gerontology International
Title: Feasibility and Preliminary Effects of a Community-Based Sutra Chanting Program on Mental Well-Being and Respiratory and Swallowing Functions in Older Adults: A Pilot Study
DOI: 10.1111/ggi.70563