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Effects of Tai Chi Chuan on Cognitive Function in Older Adults with Cognitive Impairment: A Systematic and Meta-Analytic Review

ABSTRACT: This systematic and meta-analytic review aimed to investigate the effects of Tai Chi Chuan (TCC) on the cognitive function of the elderly with cognitive impairment and to analyze the moderators of these effects. We searched eight electronic databases for randomized controlled trials on the effects of TCC on cognitive function, published up to June 14, 2020. The PEDro scale was used to evaluate the methodological quality of the included literature. Stata14.0 software was used for meta-analysis, subgroup analysis, and publication bias testing. A total of 19 studies and 1,970 samples were included. The methodological quality of the included literature was fair to good, and there was no publication bias. Overall, the research shows that the effect of TCC on the elderly with cognitive impairment is statistically significant (SMD?=?0.31, p < 0.0001). Five of the cognitive function subdomains were significant moderators [Q (5)?=?15.66, p=0.008], and the effect size (ES) was the largest for global cognitive function (SMD?=?0.41), followed by executive function (SMD?=?0.33), memory (SMD?=?0.31), and verbal fluency (SMD?=?0.27). Regarding the exercise prescription variables, results were significantly moderated by the length of exercise training [Q (2)?=?6.00, p=0.05], with ESs largest for moderate length (SMD?=?0.41), followed by short length (SMD?=?0.40) and long length (SMD?=?0.29). However, the results were not moderated by session time or frequency. TCC can improve multiple cognitive functions of the elderly with cognitive impairment. The intervention effects are moderated by exercise length, but not by exercise session time and frequency.

SUBMITTER: Cai Z

PROVIDER: S-EPMC7781704 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Project description:Tai Chi Chuan (TCC) exercise has been shown to improve cognitive task-switching performance in older adults, but the extent of this positive effect varies among individuals. Past research also shows that brain white matter integrity could predict behavioral gains of cognitive and motor learning. Therefore, in this randomized controlled trial (NCT02270320), we examined whether baseline integrity of three target white matter tract groups was predictive of task-switching improvement after 12-week TCC training in middle-aged and older adults. Thirty-eight eligible participants were randomly assigned to a TCC group (n = 19) and a control group (n = 19). Cognitive task-switching and physical performances were collected before and after training. Brain diffusion spectrum MR images were acquired before training and the general fractional anisotropy (GFA) of each target white matter tract group was calculated to indicate baseline white matter integrity of that group. Correlation and regression analyses between these GFAs and post-training task-switching improvement were analyzed using adjusted p-values. After 12 weeks, significant task-switching and physical performance improvements were found only in the TCC group. Moreover, higher baseline GFA of the prefronto-striato-thalamo-prefrontal loop fibers (r = -0.63, p = 0.009), but not of the prefronto-parietal/occipital (r = -0.55, p = 0.026) and callosal (r = -0.35, p = 0.189) fiber groups, was associated with greater reductions of task-switching errors after the TCC training. Multiple regression analysis revealed that baseline GFA of the prefronto-striato-thalamo-prefrontal loop fibers was the only independent white matter integrity predictor of task-switching error reductions after TCC training (? = -0.620, adjusted R2 change = 0.265, p = 0.009). These findings not only highlight the important role of baseline integrity of the prefronto-striatal circuits in influencing the extent of positive cognitive task-switching effects from short-term TCC training, but also implicate that preserving good white matter integrity in the aging process may be crucial in order to gain the best cognitive effects of exercise interventions.

Project description:Background: Tai Chi Chuan(TCC), as a mind-body exercise, may have a positive impact on physical function and psychological well-being in breast cancer patients. The latest systematic review and meta-analysis of TCC for breast cancer was made 4 years ago and some new clinical trials about it were published. We remade a systematic review and meta-analysis to evaluate the effect of TCC in breast cancer patients. Methods: In this systematic review and meta-analysis, we searched MEDLINE (via PubMed), EMBASE (via embase.com), CENTRAL, CNKI, COVIP, Wanfang, Chaoxing, CiNii, J-SSTAGE, DBpia, and ThaiJO with no language restrictions from inception to December 31, 2018 (updated on February 16, 2020), for randomized clinical trials comparing TCC with non-exercised therapy in breast cancer patients. The primary outcome was quality of life in patients with breast cancer and data pooled by a random-effects model. Subgroup analyses were conducted to estimate the effect of different durations of TCC for breast cancer patients. This study was registered in PROSPERO, number CRD 4201810326. Results: Fifteen articles involving a total of 885 breast cancer participants were included in this review. Compared with non-exercised therapy, TCC had a significant effect on quality of life in breast cancer patients (SMD = 0.37, 95% CI 0.15-0.59, p = 0.001), and subgroup analysis found that TCC showed beneficial effect in 12 weeks and 25 weeks (12 weeks: SMD = 0.40, 95% CI 0.19-0.62, p = 0.0003; 25 weeks: SMD = 0.38, 95% CI 0.15-0.62, p = 0.002). Meta-analyses of secondary outcomes showed that 3 weeks TCC increased shoulder function (SMD = 1.08, 95% CI 0.28-1.87, p = 0.008), 12 weeks TCC improved pain (SMD = 0.30, 95% CI 0.08-0.51, p = 0.007), shoulder function (SMD = 1.34, 95% CI 0.43-2.25, p = 0.004), strength of arm (SMD = 0.44, 95% CI 0.20-0.68, p = 0.0004), and anxiety (MD = -4.90, 95% CI -7.83 to -1.98, p = 0.001) in breast cancer patients compared with the control group. Conclusions: TCC appears to be effective on some physical and psychological symptoms and improves the quality of life in patients with breast cancer. Additional randomized controlled trials with a rigorous methodology and low risk of bias are needed to provide more reliable evidence.

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Effects of Tai Chi Chuan on Cognitive Function in Older Adults with Cognitive Impairment: A Systematic and Meta-Analytic Review

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