Tai chi effective in older people with diabetes and cognitive impairment: JAMA

In a new study by Yannan Chen and team which included senior citizens with type 2 diabetes (T2D) and mild cognitive impairment (MCI), it was shown that tai chi chuan was superior to fitness walking at enhancing general cognitive performance. The findings of this study were published in the Journal of American Medical Association.

Cognitive impairment is a condition that is progressively exacerbated by type 2 diabetes. Tai chi chuan may have longer-lasting cognitive improvements for people with T2D and mild cognitive impairment than fitness walking, although there is currently no evidence to support this claim from randomized clinical trials. Hence, this study compared the efficacy of fitness walking with tai chi chuan, a mind-body activity, for enhancing cognitive function in older persons with T2D and MCI.

At 4 locations in China, this randomized clinical trial was carried out between June 1, 2020, and February 28, 2022. 328 adults (aged 60 years) with a clinical diagnosis of T2D and MCI were participants. Participants were randomly assigned in a 1:1:1 ratio to one of three groups: tai chi chuan, fitness walking, or control. The 24-form streamlined form of tai chi chuan was taught to the tai chi group. The group that practiced fitness walking received instruction in it. For 24 weeks under supervision, both exercise groups underwent training sessions lasting 60 minutes each, three times per week. A 30-minute diabetes self-management education session was given to each of the three groups once every four weeks for a total of 24 weeks. For 36 weeks, the subjects were followed up with.

The main result was the global cognitive function assessed by the Montreal Cognitive Assessment (MoCA) at 36 weeks. Several cognitive subdomain tests, blood metabolic indices, and MoCA at 24 and 36 weeks were secondary outcomes.

The key findings of this study:

1. In the intention-to-treat analysis, a total of 328 participants were randomly assigned to the tai chi chuan group (n = 107), fitness walking group (n = 110), or control group (n = 111).

2. In the intention-to-treat analysis, the tai chi chuan group demonstrated better MoCA scores at 36 weeks compared to the fitness walking group.

3. Results from the subgroup analysis at 36 weeks and the per-protocol analysis data set were comparable.

4. The generalized linear models revealed that, after controlling for self-reported food calories and physical activity, the treatment effects were comparable in each group.

5. There were 37 minor adverse events unrelated to the trial, and there was no statistically significant difference between the three groups in these events (P =.26).

Reference:

Chen, Y., Qin, J., Tao, L., Liu, Z., Huang, J., Liu, W., Xu, Y., Tang, Q., Liu, Y., Chen, Z., Chen, S., Liang, S., Chen, C., Xie, J., Liu, J., Chen, L., & Tao, J. (2023). Effects of Tai Chi Chuan on Cognitive Function in Adults 60 Years or Older With Type 2 Diabetes and Mild Cognitive Impairment in China. In JAMA Network Open (Vol. 6, Issue 4, p. e237004). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.7004