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Is Laughter Yoga the Best Medicine for Dementia?

It may help Alzheimer’s patients and their caregivers

En Español | Do we laugh because we're happy? Or are we happy because we laugh?

Every week, yoga instructor Erika Ruiz volunteers at an Easter Seals center in Miami to exercise with 50 people diagnosed with dementia and their caregivers.

They don't arch their spines, touch their toes or wrap their ankles behind their heads. Instead, they clap hands, breathe — and laugh for no reason.

Giggles without a punch line. Guffaws without a pratfall. This is laughter yoga, a movement that's grown from five practitioners in a Mumbai park to more than 6,000 sites in 60 countries.

"Laughter is contagious, so I can engage both the people with dementia and their caregivers," said Ruiz, 46, activities director at Miami's Santovenia Adult Day Care Center, where she introduced the class in 2007.

"They're laughing together, and when you laugh you create bonds with your loved one." Laughter yoga first erupted in 1995, when a physician named Madan Kataria persuaded four friends to join him in a Mumbai park as part of his research into the health benefits of laughter. They told jokes, laughed and left. Soon the laughter club had grown to about 50 members.

Eventually, they ran out of jokes, but Kataria, reviewing his notes, had hit on the theory behind laughter yoga.

"Our body cannot differentiate between pretend and genuine laughter," he concluded.

In other words, laughing for no reason is just as healthy as laughing after a joke, and forced laughter soon gives way to real joy.

"You don't need a sense of humor to laugh," said Ruiz, who was using drum therapy with dementia patients when a Facebook friend told her about laughter yoga. Carrying laughter was easier than carrying drums, Ruiz decided, and she traveled to Chicago to become a certified instructor under Kataria's training.

"The basic idea is clapping, breathing and laughing," she explained. "Motion creates emotion."

On a recent morning, she stood before the class in the Easter Seals community room, sporting a colorful button that boasted, "We Go the Extra Smile."

"One, Two — One-Two-Three!" they began, clapping in rhythm.

Then, "Ho, Ho — Ha-Ha-Ha!"

"Expel all the air from your lungs," she told them. "Pretend you're smelling a flower."

They held imaginary flowers to their noses and took deep breaths.

"Very good, very good! Now, heart laughter."

They placed their hands on their hearts and laughed.

"Now, don't-care laughter!"

They threw up their arms and laughed even louder.

Only one older woman sat silent and uninvolved. The rest laughed, and the longer they laughed, the louder and more authentic their laughter grew.

Among the loudest was Zoila Maria Mena, 78, a client from Miami.

"It gives me a happiness inside of me," she said, still smiling after the exercise. "And to be happy is excellent because not that many people make you happy. It's good for me."

Nena Bravo, 68, of Coral Gables, does the laughter exercises with her husband, Edgar, 72, an Easter Seals client.

"It's also good for the caregivers of people with dementia," Bravo said. "Alzheimer's patients live in the moment, so when they're laughing, you can see that, in that moment, they're happy."

Laughter yoga is no cure. As Ruiz moves on to groups in more advanced stages of dementia, the response — and the laughter — dwindles. But the Easter Seals disabilities professionals remain enthusiastic.

"When I first heard about it, I thought it was silly," admitted Angela Aracena, the center's director of adult day services. "But when I saw it, it makes sense. Laughter brings more oxygen into the body and stimulates motion, stability and balance. It generates the feel-good endorphins and that boosts the immune system."

For Ruiz, who now volunteers at several Miami senior centers, the message is simple: "I'm serious about laughter."

Ron Hayes is a freelance reporter based in South Florida.