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Tai Chi Helps Maintaining Cognitive Abilities

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July 15, 2014 -
With increasing longevity, dementia care has become a major public health concern. At present, there is no drug therapy proven to delay preclinical cognitive deterioration. Practicing Tai Chi has been demonstrated to result in better cognitive function and less decline with age. A Hong Kong study compared the effectiveness of Tai Chi with stretching-and-toning exercise in the preservation of cognitive and functional decline in Chinese older persons at risk of cognitive decline.

Subjects over 65 years old were recruited from social and residential homes for the elderly. They were considered at risk of cognitive decline if they had mild cognitive impairment or amnestic mild cognitive impairment. Each participating center was considered as one unit. All subjects in a given center were randomized to the intervention or control group, so as to avoid biases due to communication between subjects within the center.

The intervention group received training on ‘24-style Tai Chi’ by a certified Tai Chi master. The complex patterns of movements entail higher cognitive demands in addition to physical exercise. The control group was trained with stretching and relaxation exercises developed by physiotherapists and conducted by an occupational therapist. The assessors were blinded to the randomization status. Comprehensive cognitive, functional, and neuropsychiatric assessments were conducted at baseline, 2, 6, and 12 months.

Of 548 participants in the 38 centers screened, 171 were randomized into the intervention and 218 in the control groups. At 1 year, 4 (4.3%) and 28 (16.6%) of the respective participants were rated as dementia. Multilevel logistic regression (controlled for baseline differences in education) revealed that the intervention group had a lower risk of developing dementia at 1 year. The change of CDR sum of boxes scores showed that the intervention group on average had a 21% better preservation (lower scores) than controls. Postural balance was measured by BBS. The intervention group had borderline better performance with time.  There were no significant changes in NPI scores across time, with a trend for lower CSDD scores from baseline to the third follow-up in both groups. The intervention group had 23% lower scores than the control group, but the difference was not significant.

Conclusions: In older adults at risk of cognitive decline, combined cognitive motor stimulation and balance training may help preserve global functioning. Further research is needed to substantiate the cognitive reserve hypothesis and its role in modifying clinical impairment in dementia.

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