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Practicing tai chi may also have cognitive benefits for older adults, research shows. MoMo Productions/Getty Images
  • A study shows that people with mild cognitive impairment related to type 2 diabetes experienced slower cognitive decline after participating in Tai chi chuan sessions.
  • The session lasted 24 weeks, during which another group performed an equivalent amount of brisk walking.
  • Compared to walking, the benefits of Tai chi chuan were greater after 36 weeks.
  • One hypothesis for the wider effect of Tai chi chuan is its emphasis on lifelong learning through constant memorization and continuous refinement of stances and movements.

According to a new study, tai chi chuan helped delay cognitive decline in people with mild cognitive impairment associated with type 2 diabetes, especially when compared to brisk walking. Researchers at Fujian University of Traditional Chinese Medicine in Fuzhou, China conducted a randomized clinical trial that demonstrated the cognitive value of the ancient martial art.

Researchers found that Tai chi chuan slowed the progression of cognitive impairment in people with type 2 diabetes more than an equivalent amount of walking exercise.

Type 2 diabetes (T2D) is frequently accompanied by a form of mild cognitive impairment (MCI) distinct from age-related cognitive decline.

The study was published in Open JAMA Network.

The study involved 328 people over the age of 60 who had been clinically diagnosed with T2DM and MCI. All participants took a 30-minute diabetes self-management course once every four weeks for 24 weeks.

Participants were randomly assigned to one of three groups. The first group received instruction in simplified Tai chi chuan in 24 forms, or “Tai chi”. The second group was trained in moderate-intensity fitness walking. The two groups each participated in 60-minute supervised tai chi or walking sessions three times a week for 24 weeks.

The third group, the control group, received no Tai chi or power walking training.

The Tai chi and walking groups scored higher on cognitive tests than the control group after 24 weeks and again at 36 weeks.

The scores for the two exercise groups were essentially the same at 24 weeks. However, after 36 weeks, the cognitive performance of the tai chi group significantly exceeded that of the power walking group, suggesting that tai chi may provide more lasting benefit.

Using the 30-point Montreal Cognitive Assessment Scale (MoCA) to rank global cognition, tai chi participants’ scores improved by 1.90 points over the control group after 36 weeks, or 0 .84 points better than the fitness walking group.

Tai chi is technically a martial art, although it is practiced throughout China as a form of non-combat activity, especially popular among older people. During a Tai chi session, an instructor guides participants through a series of positions, moving smoothly from one pose to the next. The form of Tai chi used in the study involved 24 such poses or forms.

A student of Tai chi is encouraged to participate in a continuous refinement of the poses and the transitions between them, making it a calm and gentle activity particularly well suited to middle-aged and older people.

“The study refers to Tai chi as an exercise. Tai Chi is not an exercise in itselfbut a movement that exercises the body while practicing Tai Chi movements,” said Pamela Kelley Elend of the Seattle School of Tai Chi.

Ryan Glatt of the Pacific Neuroscience Institute noted that this study involved people whose MCI is linked to T2D, and said: “So there’s probably something going on metabolically.”

Walking at a moderately brisk pace – around four miles per hour – is a form of exercise widely recommended by health experts.

“I think if you ask most people, they’re going to think walking would naturally be metabolically more intense, but they seem to be metabolically equivalent, which is interesting,” underlined Glatt.

He noted that the study authors found their Tai chi sessions to be equivalent to four metabolic equivalentsin the same way as fitness walking sessions.

“We’re kind of left to assume that it must be the cognitive demands of Tai chi, where you memorize the choreography, you pay attention, you’re constantly refining your details. So you really engage your focus, whereas with walking you’re probably able to space out a bit more,” Glatt said.

“There are many studies that prove that keeping the brain active through learning new skills creates and improves connections throughout the brain,” noted Kelley Elend.

She added that Tai Chi “allows movement to initiate from the body – as opposed to motor movement from the brain”.

“[Tai chi] allows the mind to reach and remain in a state of gentle relaxation where it can absorb new information, make new connections, while receiving energy flowing throughout the body.
—Pamela Kelley Elend

Glatt also cited the study authors’ suggestion that Tai chi may release certain growth factors, such as neurotrophic factors.

Noteworthy is how the cognitive benefits of tai chi eclipsed power walking at 36 weeks, but not at 24 weeks, Glatt said.

On the one hand, he said, “more thoughtful exercises or more cognitively engaging exercises will be more cognitively beneficial over time.”

However, he questioned whether the MoCA test used in the study was precise enough to accurately reflect differences in the effects of Tai chi and walking at 24 or 36 weeks.

“They could have used better metrics to maybe elucidate some of the changes. If they use different metrics, they might likely see improvement sooner and maybe be able to differentiate better. It’s not surprising to me if they use this way of assessing their cognition that it took so long to show improvement,” he said.

There is another way in which Tai chi can be a more durable intervention for T2D-related MCI.

“It may also be that the movement is lasting over time, [while] exercise is not, the same way dieting is not sustainable over time,” Kelley Elend said.

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