BACKGROUND: Cognitive impairment is a significant health concern among older adults, highlighting the need for non-pharmacological interventions, such as mind-body exercises. However, a comprehensive synthesis of the effects of various traditional Chinese exercises (TCEs) on cognitive function in older adults is lacking.
METHODS: A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted. Six databases were searched from inception to 2 May 2024 for studies examining the effects of TCEs on cognitive outcomes in adults aged 60 years and older. Studies were included if they were RCTs involving TCEs and reported outcome measures for global cognition, or individual cognitive domains.
RESULTS: Twenty-eight RCTs with a total of 2297 participants were included. Meta-analysis revealed that TCEs led to significant improvements in global cognition: Montreal Cognitive Assessment [mean differences (MD) = 1.67; 95% confidence interval (CI): (1.20, 2.14)], Mini-Mental State Examination [MD = 0.76; 95% CI: (0.04, 1.48)]; executive function: Trail Making Test (B-A) [MD = -7.96; 95% CI: (-15.34, -0.59)], Category Fluency for Animals [MD = 2.96, 95% CI (2.08, 3.85)]; working memory: Digit Span-Backwards [MD = 0.48; 95% CI: (0.07, 0.90)]; processing speed: Digit Symbol Coding [MD = 4.16; 95% CI: (1.82, 6.50)]; memory function: Memory Quotient [MD = 13.13; 95% CI: (4.06, 22.20)], Auditory Verbal Learning Test: immediate recall [MD = 1.13; 95% CI: (0.07, 2.20)], short-term delayed recognition [MD = 0.80; 95% CI: (0.28, 1.32)] and long-term delayed recognition [MD = 1.38; 95% CI: (0.68, 2.09)].
CONCLUSIONS: TCEs are effective in improving cognitive function in older adults, particularly in domains such as global cognition, executive function, working memory, processing speed and memory function. However, given the methodological limitations and heterogeneity of the included studies, these findings require confirmation in further large-scale, high-quality RCTs.
| Discipline Area | Score |
|---|---|
| Family Medicine (FM)/General Practice (GP) |  |
| General Internal Medicine-Primary Care(US) | |
| Geriatrics |  |
| Neurology | |
Tai Chi and other eastern disciplines improve cognitive function. This well-designed meta-analysis demonstrates objective improvement and, with other recent studies, suggests that Tai Chi may be a solid method to help preserve cognitive function. The practice will need to be sustained to maintain improvement.
While practicing geriatricians might know that Tai Chi is safe and benefits cognition, the consistency of findings across RCTs and recognizing that heterogeneity is primarily from the type of exercise is newsworthy.
Large effect size, but a significant dropout rate. It needs a comparison in Western subjects and alternate exercise regimes, such as walking.
