Effect of Tai Chi on Cognitive Function among Older Adults with Cognitive Impairment: A Systematic Review and Meta-Analysis

Tuesday, 17 August 2021

Cognitive decline occurs in all persons during the aging process and drugs can only alleviate symptoms and are expensive. Some researches demonstrated that Tai Chi had potential in preventing cognitive decline while others’ results showed Tai Chi had no influence on cognitive impairment. Therefore, we conduct a systematic review and meta-analysis to assess the efficacy and safety of cognitive impairment patients practicing Tai Chi.

Abstract

Background. Cognitive decline occurs in all persons during the aging process and drugs can only alleviate symptoms and are expensive. Some researches demonstrated that Tai Chi had potential in preventing cognitive decline while others’ results showed Tai Chi had no influence on cognitive impairment. Therefore, we conduct a systematic review and meta-analysis to assess the efficacy and safety of cognitive impairment patients practicing Tai Chi. Methods. A comprehensive literature search was carried out in multiple databases, including PubMed, Cochrane, MEDLINE (Ovid), Web of Science, Embase, Scopus, PsycInfo (Ovid), CKNI, Wan Fang, VIP, SinoMed, and ClinicalTrails, from their inception to 1 July 2020 to collect randomized controlled trials about practicing Tai Chi for patients with cognitive impairment. Primary outcomes included changes of cognitive function and secondary outcomes included changes of memory functions. Data were extracted by two independent individuals and Cochrane Risk of Bias tool version 2.0 was applied for the included studies. Systematic review and meta-analysis were performed by RevMan 5.3 software. Results. The results included 827 cases in 9 studies, of which 375 were in the experimental group and 452 were in the control group. Meta-analysis showed that Mini-Mental State Examination WMD = 1.52, 95% CI [0.90, 2.14]; Montreal Cognitive Assessment WMD = 3.5, 95% CI [0.76, 6.24]; Clinical Dementia Rating WMD = −0.55, 95% CI [−0.80, −0.29]; logical memory delayed recall WMD = 1.1, 95% CI [0.04, 2.16]; digit span forward WMD = 0.53, 95% CI [−0.65, 1.71]; and digit span backward WMD = −0.1, 95% CI [−0.38, 0.19]. No adverse events were reported in the included articles. Conclusion. There is limited evidence to support that practicing Tai Chi is effective for older adults with cognitive impairment. Tai Chi seems to be a safe exercise, which can bring better changes in cognitive function score.

Introduction

While social aging is a trend, cognitive decline can occur for everyone. Eventually, this may result in mild cognitive impairment and dementia [1]. Mild cognitive impairment occurs along a continuum from normal cognition to dementia [2]. It is widely recognized as the intermediate stage of cognitive impairment between the changes seen in normal cognitive aging and dementia [3]. At present, drugs for cognitive impairment can only alleviate the symptoms of cognitive disorders and their price is usually high. Therefore, complementary and alternative therapies have become a hot research topic for improving cognitive impairment in recent years [4].

Tai Chi has a long history and culture. Participants take deep breathing and mental concentration in order to carrying out smooth and continuous body movements [5]. It combines Chinese martial arts and meditative movements that promote balance of mind and body for healing [6]. Physical exercise and fitness have been proposed as potential factors that may promote healthy cognitive aging [7] and aerobic exercise was proven to improve cognitive function in adults with neurological disorders [8]. In recent years, long-term cognitive training and physical exercise had been confirmed its benefits for delaying the cognitive decline for the elderly [9, 10]. Tai Chi might improve memory and executive function in older adults with amnestic-mild cognitive impairment, possibly via an upregulation of brain-derived neurotrophic factor [11, 12]. The studies suggested Tai Chi has impacts on global cognitive functions, visuospatial skills, semantic memory, verbal learning memory, and self-perception of memory [13]. It may also have direct benefits on enhancing attention and executive functions [14].

At present, a growing body of evidence supports that Tai Chi may help improve cognitive function and mental well-being for older adults with mild dementia [15, 16]. It also proved that Tai Chi has psychophysiological benefits for motor coordination and memory [1720]. However, some studies reported no significant differences in assessment of cognitive function [21]. Previous meta-analysis revealed that Tai Chi had no influence on individuals with cognitive impairment [22]. In addition, previous meta-analysis only searched the English databases [23] while Tai Chi is most practiced in China. Therefore, we will conduct a meta-analysis and systematic review without language limitation to assess the effect of Tai Chi on cognitive function among older adults with cognitive impairment.

Conclusion

There is limited evidence supporting that practicing Tai Chi can bring better changes in cognitive function score (MMSE, MoCA, CDR, and LMD). However, there is no influence on DSF and DSB. Current evidence indicates that Tai Chi is a safe exercise for people with cognitive impairment. There is still a need for increasing RCTs to address whether practicing Tai Chi is effective for patients with cognitive impairment.

Full article

The full article is available at: https://www.hindawi.com/journals/ecam/2021/6679153/