Project Summary/Abstract Abstract: The world's population is rapidly aging, putting intense pressure on healthcare systems in both developed and developing countries. The number of people aged 60 years or older is estimated to increase from 900 million in 2015, to 2.1 billion by 2050. Almost a fourth of the global burden of disease arises in in older people; and chronic conditions are increasingly concentrated in the elderly in low- and middle-income countries. Since almost half of the lifetime costs for medical services are incurred after 65 years of age— healthcare systems face huge and increasing financial burdens related to multimorbidity in the elderly. Current intervention approaches are poorly suited to older patients with multiple, co-occurring, and inter-related conditions. Multimorbidity is commonly manifested in frailty, impaired cognition, incontinence, gait and balance disorders that present significant challenges for effective intervention. Comprehensive and holistic approaches that improve both physical health and subjective well-being, are required. Seniors Yoga, a form of yoga tailored to be safe, gentle, and helpful for elderly, represents a promising strategy for addressing multimorbidity in this population. It has been recommended as a healthy aging strategy in the Go4Life campaign of the National Institute of Aging. Yoga, a mind-body practice with origins in ancient Indian philosophy combines physical postures, breathing techniques, meditation, and relaxation. Many age-related morbidities respond well to holistic approaches like yoga since they contain physical activity (e.g. diet, exercise), mental and emotional training, social interactions, and, potentially, even engagement with a spiritual dimension. There are currently no evidence-based implementation models for integration of yoga practice for seniors in primary health care in low resource settings. The overall goal of this proposed grant is to carry out a contextual adaptation of a previously designed yoga intervention for seniors in a community- based sample of the elderly living in urban slums in Mysore, India. The proposed research fits with priorities of National Institute of Aging which includes gaining a “better understanding of interventions that reduce the burden on family caregivers to improve the health of the aging care recipient”. The goal of this initiative is to adapt an evidence-based yoga lifestyle intervention for use in primary care settings to address the physical and mental needs of seniors aged 60 -80 years living in urban slums of Mysore, India. The results from this study will help plan an R34 application that will provide early stage feasibility data for a larger randomized controlled trial.