Enhanced tai chi program found to improve cognition, executive function in older adults with mild cognitive impairment

A study of more than 300 older adults experiencing mild cognitive impairment or self-reported memory concerns has found that cognitively enriched tai ji quan, also known as tai chi, was superior to standard tai ji quan or stretching for improving global cognition and reducing walking interference associated with dual tasking.

The authors note that the virtual, home-based exercise program also had high fidelity and adherence, suggesting that it could be a feasible, acceptable exercise-based therapy for older adults concerned about cognitive impairment. The findings are published in Annals of Internal Medicine.

Mild cognitive impairment is characterized by decline in functional cognition and affects 16–20% of people aged older than 65 years. The condition can cause memory and thinking problems and impair dual-task performance, and consequently, interfere with complex tasks of daily living. Both cognitive decline and impaired dual-task performance are associated with a higher risk for falls, increased health care costs, and increased mortality. Current clinical guidelines recommend exercise to preserve cognitive function and mitigate decline in older adults, but the effects of cognitively enhanced tai chi are not fully understood.

Researchers from Oregon Research Institute randomly assigned 318 adults with self-reported memory decline and a Clinical Dementia Rating (CDR) global score of 0.5 or lower at baseline to engage in cognitively enhanced tai ji quan, standard tai ji quan, or stretching 1 hour twice weekly for 24 weeks via videoconferencing to compare the effectiveness of the interventions for improving global cognition and reducing dual-task walking costs.

The authors found that cognitively enhanced tai ji quan significantly improved global cognition and lowered cognitive costs associated with dual-task walking at 24 weeks compared with standard tai ji quan or stretching. Favorable improvements were also seen in cognition and function, executive function, and working memory compared with the other two interventions and the effects were sustained at 48 weeks. The intervention was safe, with few mild adverse events reported.