Can laughter improve wellbeing in older people?

Laughter is a universal sign of joy. It is contagious and likely evolved long before language as a way to communicate and elicit humour, which in turn helped to strengthen the bonds between social groups.

Studies have suggested that it also has several physical and psychological health benefits, including:

• Decreasing stress hormones and boosting the immune system
• Reducing pain
• Improving mood
• Increasing resilience

As the psychological and physiological effects of laughing can increase optimism, energy and cognitive function, while decreasing anxiety, stress, loneliness, depression and tension, there is a great deal of interest in interventions which focus on inducing laughter.

In other words, laughter really may be the best medicine after all.

Older people and laughter

With all the benefits of laughing, older people – who may laugh relatively less than younger age groups – may be missing out in terms of their health, wellbeing and social interactions.

Wellbeing, defined by the World Health Organisation (Five) Wellbeing Index as including feeling cheerful, active, relaxed, rested and interested in life, is thought to buffer physical and mental disease, and benefit health maintenance in older adults.

The prevalence of chronic disease, multiple long-term conditions and psychosocial issues among older people requires action, including prioritising their wellbeing, according to the WHO.

Using laughter as therapy

Therapeutic laughter has a long history, but the scientific study of laughter (known as gelotology, as gelos is Greek for laughter) dates to 1964 when Dr William Fry, a humour researcher, founded the Institute of Gelotology at Stanford University. Fry highlighted the value of humour and laughter in the ageing process, and demonstrated its benefits on blood pressure and the cardiovascular system.

As evidence of its ability to reduce stress and pain, relax muscles and benefit the cognitive and immune systems emerged, laughter therapies were legitimised and developed. Most were based on humour and comedy, for example Patch Adams’ clown therapy.

Laughter interventions which dispensed with humour were popularised by Dr Madan Kataria in India. He added joke-telling to his yoga classes in 1995 to harness the health benefits of laughing and, when the jokes ran out, he advised participants to ‘laugh for no reason’. The idea of ‘faking’ laughter as therapy was not new, but the scale was. According to Kataria, thousands of laughter yoga clubs exist combining breathing techniques with clapping and playful exercises. Laughter qigong, promoted for health in Taiwan since 1998, uses principles of Chinese medicine and emphasises breathing and core strength.

A systemic review of laughter and humour interventions

Working together with my research supervisor Dr Gulcan Garip, Health Psychologist at the University of Derby Online Learning, I recently published a systematic review of studies into laughter and humour interventions to improve wellbeing in older adults in Complementary Therapies in Medicine.

The review included five studies, with a total of 369 participants, and aimed to bring more insight into the effectiveness of laughing as a way of increasing wellbeing.

Some of the studies used humour to elicit laughter, while others focused on self-induced laughter. The interventions included laughter yoga, a laughter and exercise programme, laughter qigong and laughter therapy.

My review found that all of the interventions appeared to have a tendency to increase wellbeing and wellbeing-related factors in older adults. However, participant laughing – including whether, how often, how intensely or for how long each participant laughed – was not explicitly measured in these studies.

I also developed an intervention classification system to help guide the design and composition of future laughter and humour interventions, because intervention development is no laughing matter!

Read the full review on ResearchGate