Reduce Falls in the Elderly with Exercise and Tai Chi

April 8, 2020 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“With regular practice, tai chi improves balance by strengthening muscles and co-ordination; at the same time, it strengthens the mind, thereby improving calmness and confidence in not falling. Thus, both physically and mentally, tai chi is an extremely effective exercise for fall prevention. A great bonus, at the same time, tai chi also improves almost all aspects of health!” – Paul Lam

The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.

Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of falls in the elderly.

Tai Chi training is designed to enhance and regulate the functional activities of the body through regulated breathing, mindful concentration, and gentle movements. It includes balance training and has been shown to improve balance and coordination. Indeed, Tai Chi training has been shown to reduce the frequency of falls in the elderly. It is not known, however, how effective Tai Chi training is in preventing falls relative to other exercises. The evidence is accumulating. So, it is important to review and summarize what has been learned.

In today’s Research News article “Exercise for preventing falls in older people living in the community.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360922/), Sherrington and colleagues review, summarize, and perform a meta-analysis of the relative effectiveness of various exercises, including Tai Chi in improving balance and reducing falls in the elderly. They identified 108 randomized controlled trials including a total of 23,407 participants averaging 77 years of age employing any form of exercise and measuring falls before and after treatment.

They report that the published research found that all forms of exercise combined significantly reduced falls by 23% and reduced the number of people experiencing falls by 15% with larger effects when the program was delivered by a health care professional. With respect to specific forms of exercise they found that balance and functional exercises significantly reduced falls by 24% and reduced the number of people experiencing falls by 13% while Tai Chi significantly reduced falls by 19% and reduced the number of people experiencing falls by 20%. There were too few studies with mixed resultsmof other forms of exercise such as walking, dance, strength exercises to evaluate their effectiveness.

These findings support the use of exercise to reduce falls in the elderly including the use of Tai Chi. Some advantages of Tai Chi include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to reduce falls in elderly individuals.

So, reduce falls in the elderly with exercise and Tai Chi.

“based on current available evidence, suggest that Tai Chi exercise is an effective intervention to prevent the risk of falls among older adults.” – Yu-Ning Hu

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. The Cochrane database of systematic reviews, 1(1), CD012424. https://doi.org/10.1002/14651858.CD012424.pub2

Abstract

Background

At least one‐third of community‐dwelling people over 65 years of age fall each year. Exercises that target balance, gait and muscle strength have been found to prevent falls in these people. An up‐to‐date synthesis of the evidence is important given the major long‐term consequences associated with falls and fall‐related injuries

Objectives

To assess the effects (benefits and harms) of exercise interventions for preventing falls in older people living in the community.

Search methods

We searched CENTRAL, MEDLINE, Embase, three other databases and two trial registers up to 2 May 2018, together with reference checking and contact with study authors to identify additional studies.

Selection criteria

We included randomised controlled trials (RCTs) evaluating the effects of any form of exercise as a single intervention on falls in people aged 60+ years living in the community. We excluded trials focused on particular conditions, such as stroke.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. Our primary outcome was rate of falls.

Main results

We included 108 RCTs with 23,407 participants living in the community in 25 countries. There were nine cluster‐RCTs. On average, participants were 76 years old and 77% were women. Most trials had unclear or high risk of bias for one or more items. Results from four trials focusing on people who had been recently discharged from hospital and from comparisons of different exercises are not described here.

Exercise (all types) versus control

Eighty‐one trials (19,684 participants) compared exercise (all types) with control intervention (one not thought to reduce falls). Exercise reduces the rate of falls by 23% (rate ratio (RaR) 0.77, 95% confidence interval (CI) 0.71 to 0.83; 12,981 participants, 59 studies; high‐certainty evidence). Based on an illustrative risk of 850 falls in 1000 people followed over one year (data based on control group risk data from the 59 studies), this equates to 195 (95% CI 144 to 246) fewer falls in the exercise group. Exercise also reduces the number of people experiencing one or more falls by 15% (risk ratio (RR) 0.85, 95% CI 0.81 to 0.89; 13,518 participants, 63 studies; high‐certainty evidence). Based on an illustrative risk of 480 fallers in 1000 people followed over one year (data based on control group risk data from the 63 studies), this equates to 72 (95% CI 52 to 91) fewer fallers in the exercise group. Subgroup analyses showed no evidence of a difference in effect on both falls outcomes according to whether trials selected participants at increased risk of falling or not.

The findings for other outcomes are less certain, reflecting in part the relatively low number of studies and participants. Exercise may reduce the number of people experiencing one or more fall‐related fractures (RR 0.73, 95% CI 0.56 to 0.95; 4047 participants, 10 studies; low‐certainty evidence) and the number of people experiencing one or more falls requiring medical attention (RR 0.61, 95% CI 0.47 to 0.79; 1019 participants, 5 studies; low‐certainty evidence). The effect of exercise on the number of people who experience one or more falls requiring hospital admission is unclear (RR 0.78, 95% CI 0.51 to 1.18; 1705 participants, 2 studies, very low‐certainty evidence). Exercise may make little important difference to health‐related quality of life: conversion of the pooled result (standardised mean difference (SMD) ‐0.03, 95% CI ‐0.10 to 0.04; 3172 participants, 15 studies; low‐certainty evidence) to the EQ‐5D and SF‐36 scores showed the respective 95% CIs were much smaller than minimally important differences for both scales.

Adverse events were reported to some degree in 27 trials (6019 participants) but were monitored closely in both exercise and control groups in only one trial. Fourteen trials reported no adverse events. Aside from two serious adverse events (one pelvic stress fracture and one inguinal hernia surgery) reported in one trial, the remainder were non‐serious adverse events, primarily of a musculoskeletal nature. There was a median of three events (range 1 to 26) in the exercise groups.

Different exercise types versus control

Different forms of exercise had different impacts on falls (test for subgroup differences, rate of falls: P = 0.004, I² = 71%). Compared with control, balance and functional exercises reduce the rate of falls by 24% (RaR 0.76, 95% CI 0.70 to 0.81; 7920 participants, 39 studies; high‐certainty evidence) and the number of people experiencing one or more falls by 13% (RR 0.87, 95% CI 0.82 to 0.91; 8288 participants, 37 studies; high‐certainty evidence). Multiple types of exercise (most commonly balance and functional exercises plus resistance exercises) probably reduce the rate of falls by 34% (RaR 0.66, 95% CI 0.50 to 0.88; 1374 participants, 11 studies; moderate‐certainty evidence) and the number of people experiencing one or more falls by 22% (RR 0.78, 95% CI 0.64 to 0.96; 1623 participants, 17 studies; moderate‐certainty evidence). Tai Chi may reduce the rate of falls by 19% (RaR 0.81, 95% CI 0.67 to 0.99; 2655 participants, 7 studies; low‐certainty evidence) as well as reducing the number of people who experience falls by 20% (RR 0.80, 95% CI 0.70 to 0.91; 2677 participants, 8 studies; high‐certainty evidence). We are uncertain of the effects of programmes that are primarily resistance training, or dance or walking programmes on the rate of falls and the number of people who experience falls. No trials compared flexibility or endurance exercise versus control.

Authors’ conclusions

Exercise programmes reduce the rate of falls and the number of people experiencing falls in older people living in the community (high‐certainty evidence). The effects of such exercise programmes are uncertain for other non‐falls outcomes. Where reported, adverse events were predominantly non‐serious.

Exercise programmes that reduce falls primarily involve balance and functional exercises, while programmes that probably reduce falls include multiple exercise categories (typically balance and functional exercises plus resistance exercises). Tai Chi may also prevent falls but we are uncertain of the effect of resistance exercise (without balance and functional exercises), dance, or walking on the rate of falls.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360922/

Improve Emotional Distress in The Elderly with Type 2 Diabetes with Mindfulness

March 25, 2020 psyjdc Leave a comment

Improve Emotional Distress in The Elderly with Type 2 Diabetes with Mindfulness

By John M. de Castro, Ph.D.

“Mindfulness based approaches has been found to be particularly effective in supporting diabetes management and the mental turmoil that is accompanied with a diagnosis of such as chronic physical illness. It can address the feelings of guilt, anger and aid self-acceptance to encourage the fulfilment of an unobstructed life. Mindfulness has also been found to have an enhanced clinical effect of glycemic control so not only aids psychological health but could potentially have a positive impact on the management of the physical condition.” – Diabetes UK

Diabetes is a major health issue. It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Type 2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

Type 2 diabetes is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Current treatments for Type 2 Diabetes focus on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes.

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. The problems resulting from diabetes get magnified in the elderly. So, it is important to study the efficacy of ACT for Type 2 Diabetes in the elderly.

In today’s Research News article “Efficacy of Acceptance And Commitment Therapy For Emotional Distress In The Elderly With Type 2 Diabetes: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802537/), Maghsoudi and colleagues recruited patients with Type 2 Diabetes over 60 years of age. They all continued on routine care while half were randomly selected to receive Acceptance and Commitment Therapy (ACT) in groups once a week for 90 minutes for 8 weeks. They were measured before and after training and 2 months later for diabetes-related emotional distress including the dimensions of emotional burden, physician-related distress, regimen-related distress and diabetes-related interpersonal distress.

They found that in comparison to baseline and the usual care group the patients who received Acceptance and Commitment Therapy (ACT) had significantly lower diabetes-related emotional distress. This lower diabetes-related emotional distress was maintained 2 months later. The study contained only a passive control condition, so caution must be exercised in interpreting the results. Nevertheless, ACT\ was a safe, effective, and lasting treatment to improve the emotions of elderly patients with Type 2 Diabetes.

So, improve emotional distress in the elderly with Type 2 Diabetes with mindfulness.

“Mindfulness training, including focused breathing and awareness training, helped U.S. veterans with diabetes significantly lower their diabetes-related distress and blood sugar levels and improve their self-management of the disease, researchers report.” – Science Daily

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Maghsoudi, Z., Razavi, Z., Razavi, M., & Javadi, M. (2019). Efficacy Of Acceptance And Commitment Therapy For Emotional Distress In The Elderly With Type 2 Diabetes: A Randomized Controlled Trial. Diabetes, metabolic syndrome and obesity : targets and therapy, 12, 2137–2143. doi:10.2147/DMSO.S221245

Abstract

Introduction

Diabetes is among the common diseases in the elderly which results in depression, anxiety, and emotional distress in the elderly and impacts the disease control by the individual. This study was conducted with the aim of exploring the effectiveness of acceptance and commitment therapy (ACT) in the improvement of emotional distress in the elderly with type 2 diabetes.

Materials and methods

In this randomized control trial, 80 elderly with type 2 diabetes aged ≥60 years were randomly selected among the individuals visiting Yazd Diabetes Research Center. Then, the patients were randomly divided into two 40 individual groups, ie, the intervention group and the control group. The intervention group underwent group ACT during eight 90-min sessions. The diabetes-related emotional distress questionnaire was completed before the intervention, after the end of the group sessions and 2 months after that. The statistical software SPSS version 21 was used for data analysis.

Results

The emotional mean scores in the intervention and control groups were not significantly different before the intervention. However, the mean score of the intervention group was lower than of the control group immediately after the intervention (p=0.02) and 2 months after the intervention (p=0.02).

Conclusion

ACT results in the improvement of diabetes-related emotional distress in the intervention group. Considering the effectiveness of ACT, this therapeutic method is recommended to be used for the amelioration of emotional distress in the elderly with type 2 diabetes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802537/

Improve Health and Cognitive Ability in the Elderly with Tai Chi

March 20, 2020 psyjdc Leave a comment

Improve Health and Cognitive Ability in the Elderly with Tai Chi

By John M. de Castro, Ph.D.

“Tai chi is a gentle exercise that helps seniors improve balance and prevent falls. Studies have found that tai chi also improves leg strength, cardiovascular endurance, flexibility, immune system, sleep, happiness, sense of self-worth, and the ability to concentrate and multitask during cognitive tests.” – DailyCaring

Human life is one of constant change. We revel in our increases in physical and mental capacities during development, but regret their decreases during aging. The aging process involves a systematic progressive decline in every system in the body. It is inevitable and cannot be avoided. This includes our mental abilities which decline with age including impairments in memory, attention, and problem-solving ability, and in emotion regulation. There is some hope for age related decline, however, as there is evidence that it can be slowed. There are some indications that physical and mental exercise can reduce the rate of decline. For example, contemplative practices such as meditation, yoga, and Tai Chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline with aging

In today’s Research News article “The Effects of Tai Chi on Markers of Atherosclerosis, Lower-limb Physical Function, and Cognitive Ability in Adults Aged Over 60: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6427726/), Zhou and colleagues recruited healthy elderly (aged 60-79 years) who were not practicing Tai Chi or other mindful movement practices and randomly assigned them to engage in one of three different Tai Chi practices for 12 weeks. The practices contained either 24, 42, or 56 different movements. They attended 3 times weekly Tai Chi classes. For the first 6 weeks the classes were 60 minutes while for the second 6 weeks the classes were 90 minutes. They were measured at baseline and at 6 and 12-weeks of practice for resting heart rate and as markers of atherosclerosis resting ankle brachial index and ankle pulse wave velocity. They were also measured for cognitive ability and movement tests of chair rise, walking, balance, and up-and-go test.

They found that for both males and females all three Tai Chi practices produced significant improvements in health-related outcomes at 6 and 12 weeks including improvements in walking, balance, up-and-go test, and ankle brachial index. Compared to the 24-movement practice, the 42- and 56-movement practices produced significantly better results for walking and balance and the resting ankle brachial index indicator of atherosclerosis. There were no adverse events recorded.

These results have to be interpreted with caution as there wasn’t a control condition such as a different exercise and there was no long-term follow-up. Nevertheless, the results suggest that Tai Chi practices is safe and effective treatment to produce significant improvements in the elderly’s movements, balance, and atherosclerosis. The 24-movement practice appears to be inferior to Tai Chi practices containing a greater number of distinct movements. Supporting these findings is the fact that these improvements including improved balance, movement, cardiovascular performance have also been documented in prior research.

Tai Chi practice is gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. All of these characteristics make Tai Chi practice an excellent practice to improvement the health of the elderly.

So, improve health and cognitive ability in the elderly with Tai Chi

“Practicing Tai Chi regularly is known to enhance health and fitness. It can also help seniors with a better sense of balance and strength.” – MedicalAlert

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Zhou, S., Zhang, Y., Kong, Z., Loprinzi, P. D., Hu, Y., Ye, J., … Zou, L. (2019). The Effects of Tai Chi on Markers of Atherosclerosis, Lower-limb Physical Function, and Cognitive Ability in Adults Aged Over 60: A Randomized Controlled Trial. International journal of environmental research and public health, 16(5), 753. doi:10.3390/ijerph16050753

Abstract

Objective: The purpose of this study was to investigate the effects of Tai Chi (TC) on arterial stiffness, physical function of lower-limb, and cognitive ability in adults aged over 60. Methods: This study was a prospective and randomized 12-week intervention trial with three repeated measurements (baseline, 6, and 12 weeks). Sixty healthy adults who met the inclusion criteria were randomly allocated into three training conditions (TC-24, TC-42, and TC-56) matched by gender, with 20 participants (10 males, 10 females) in each of the three groups. We measured the following health outcomes, including markers of atherosclerosis, physical function (leg power, and static and dynamic balance) of lower-limb, and cognitive ability. Results: When all three TC groups (p < 0.05) have showed significant improvements on these outcomes but overall cognitive ability at 6 or 12 weeks training period, TC-56 appears to have superior effects on arterial stiffness and static/dynamic balance in the present study. Conclusions: Study results of the present study add to growing body of evidence regarding therapeutic TC for health promotion and disease prevention in aging population. Future studies should further determine whether TC-42 and TC-56 are beneficial for other non-Chinese populations, with rigorous research design and follow-up assessment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6427726/

Increase Telomere Length and Decrease Cellular Aging with Meditation

March 18, 2020April 28, 2022 psyjdc Leave a comment

Increase Telomere Length and Decrease Cellular Aging with Meditation

By John M. de Castro, Ph.D.

“some forms of meditation may have salutary effects on telomere length by reducing cognitive stress and stress arousal and increasing positive states of mind and hormonal factors that may promote telomere maintenance.” – Elissa Epel

One of the most exciting findings in molecular biology in recent years was the discovery of the telomere. This is a component of the DNA molecule that is attached to the ends of the strands. Recent genetic research has suggested that the telomere and its regulation is the biological mechanism that produces aging. It has been found that the genes, coded on the DNA molecule, govern cellular processes in our bodies. One of the most fundamental of these processes is cell replication. Cells are constantly turning over. Dying cells or damaged are replaced by new cells. The cells turn over at different rates but most cells in the body are lost and replaced between every few days to every few months. Needless to say, we’re constantly renewing ourselves.

As we age the tail of the DNA molecule called the telomere shortens. When it gets very short cells have a more and more difficult time reproducing and become more likely to produce defective cells. On a cellular basis, this is what produces aging. As we get older the new cells produced are more and more likely to be defective. The shortening of the telomere occurs each time the cell is replaced. So, slowly as we age it gets shorter and shorter. This has been called a “mitotic clock.” This is normal. But telomere shortening can also be produced by oxidative stress, which can be produced by psychological and physiological stress. This is mediated by stress hormones and the inflammatory response. So, chronic stress can accelerate the aging process. In other words, when we’re chronically stressed, we get older faster.

Fortunately, there is a mechanism to protect the telomere. There is an enzyme in the body called telomerase that helps to prevent shortening of the telomere. It also promotes cell survival and enhances stress-resistance. Research suggests that processes that increase telomerase activity tend to slow the aging process by protecting the telomere. One activity that seems to increase telomerase activity and protect telomere length is mindfulness practice. Hence, engaging in mindfulness practices may protect the telomere and thereby slow the aging process. There is accumulating evidence, so it makes sense to stop and summarize what has been learned.

In today’s Research News article “Meditation and telomere length: a meta-analysis.” (See summary below or view the full text of the study at: https://doi.org/10.1080/08870446.2019.1707827 ), Schutte and colleagues review, summarize, and perform a meta-analysis on the effects of meditation practice on cellular aging as reflected in telomere lengths. They identified 12 controlled published research studies.

They found that the published research demonstrated that meditation practices produce longer telomere lengths. The effect sizes were moderate and indicated that the meditation practitioners had telomeres about a half of a standard deviation longer then controls. They also report that the greater the number of hours of meditation practice the longer the telomeres, but this relationship was not significant in studies where there was a random assignment of participants to groups.

These are exciting findings that suggest that meditation practice can lead to greater telomere length. This in turn suggests that meditation would improve health and longevity. It is suspected that meditation has these benefits as the result of the ability of meditation practice to reduce the psychological and physiological responses to stress, where stress is known to have a shortening effect on the telomeres. Regardless of the mechanism, the accumulating research suggests that meditation can reduce cellular aging and thereby improve health and longevity.

Increase telomere length and decrease cellular aging with meditation.

“meditation and the like, which people can use to reduce stress and increase wellbeing, would be having their salutary and well-documented useful effects in part through telomeres.” – Elizabeth Blackburn

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Nicola S. Schutte, John M. Malouff & Shian-Ling Keng (2020): Meditation and telomere length: a meta-analysis, Psychology & Health, DOI: 10.1080/08870446.2019.1707827

ABSTRACT Objective: Telomeres are the caps at the end of chromosomes. Short telomeres are a biomarker for worsening health and early death. Design: The present study consolidated research on meditation and telomere length through a meta-analysis of results of studies examining the effect of meditation on telomere length by comparing the telomere length of meditating participants with participants in control conditions. Results: A search of the literature identified 11 studies reporting 12 comparisons of meditating individuals with individuals in control conditions. An overall significant weighted effect size of g ¼.40 indicated that the individuals in meditation conditions had longer telomeres. When an outlier effect size was trimmed from the analysis, the effect size was smaller, g ¼.16. Across studies, a greater number of hours of meditation among participants in meditation conditions was associated with larger effect sizes. Conclusion: These findings provide tentative support for the hypothesis that participants in meditation conditions have longer telomeres than participants in comparison conditions, and that a greater number of hours of meditation is associated with a greater impact on telomere biology. The results of the meta-analysis have potential clinical significance in that they suggest that meditation-based interventions may prevent telomere attrition or increase telomere length.

https://doi.org/10.1080/08870446.2019.1707827

Improve Brain Function and Mild Cognitive Impairment in the Elderly with Tai Chi

February 21, 2020 psyjdc Leave a comment

Improve Brain Function and Mild Cognitive Impairment in the Elderly with Tai Chi

By John M. de Castro, Ph.D.

“in individuals age 60 or older with mild cognitive impairment . . . engaging in tai chi (a series of gentle, slow movements accompanied by deep breathing) reduces the risk of falling. What’s more, it may also improve cognitive abilities.” – Health and Wellness Alerts

The aging process involves a systematic progressive decline in every system in the body, the brain included. The elderly frequently have problems with attention, thinking, and memory, known as mild cognitive impairment. An encouraging new development is that mindfulness practices such as meditation training and mindful movement practices can significantly reduce these declines in cognitive ability. In addition, it has been found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation, yoga, and Tai Chi have been found to degenerate less with aging than non-practitioners.

Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Tai Chi practice has been found to be effective for an array of physical and psychological issues. Tai Chi has been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain. So, it makes sense to further study the effectiveness of Tai Chi training on older adults with mild cognitive impairment to improve their cognitive performance.

In today’s Research News article “Mind-body exercise improves cognitive function and modulates the function and structure of the hippocampus and anterior cingulate cortex in patients with mild cognitive impairment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6535682/), Tao and colleagues recruited sedentary patients over 60 years of age who were diagnosed with mild cognitive impairment. They were randomly assigned to receive 24 weeks, 3 times per week for 1 hour, of either Baduanjin Tai Chi or brisk walking, or 8 weeks, once a week for 30 minutes of health education. They were measured before and after the 24 weeks of training for cognitive function including naming, verbal memory registration, visuospatial/executive functions, and learning, attention, and abstraction. Their brains were also scanned with functional Magnetic Resonance Imaging (fMRI) before and after training.

They found that the group that practiced Baduanjin Tai Chi had significant improvements in cognitive functions that were about double those of the walking and health education groups. In the fMRI data they investigated the resting state amplitude of low-frequency fluctuations (ALFF), that is linked with cerebral blood flow. They found that Baduanjin Tai Chi group had significant decreases in ALFF in the right hippocampus and significant increases in the left medial prefrontal cortex and the anterior cingulate cortex. They also found that the Baduanjin Tai Chi group had significant increases in grey matter volume in the right hippocampus and the anterior cingulate cortex and increased functional connectivity between the hippocampus and right angular gyrus. Importantly, they found that the greater the change in the ALFF for the right hippocampus and also the anterior cingulate cortex the greater the improvement in cognitive function.

The hippocampus has been shown to be involved in information storage (memory). Since one of the biggest changes that accompany mild cognitive impairments are deficits in memory, it seems logical that interventions that improve cognitive function in these patients would affect the brain structure involved in the memory process.

These are very interesting results from a well-controlled study. They suggest that participation in Baduanjin Tai Chi changes the brain and increases cognitive function in patients with mild cognitive impairments. These results are in line with previous findings that Tai Chi improves cognitive function, memory, and reduces age related deterioration of the brain in the elderly. The results also suggest that the changes in the brain are associated with the changes in cognitive ability.

It’s important to note that Tai Chi is gentle and safe, appropriate for all ages, and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. Overall, the results suggest that participation in Tai Chi should be recommended for patients with mild cognitive impairments.

So, improve brain function and mild cognitive impairment in the elderly with Tai Chi

“adults with mild cognitive impairment . . . found that a 12-week exercise program significantly improved performance on a semantic memory task, and also significantly improved brain efficiency.” – About Memory

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Tao, J., Liu, J., Chen, X., Xia, R., Li, M., Huang, M., … Kong, J. (2019). Mind-body exercise improves cognitive function and modulates the function and structure of the hippocampus and anterior cingulate cortex in patients with mild cognitive impairment. NeuroImage. Clinical, 23, 101834. doi:10.1016/j.nicl.2019.101834

Abstract

Mild cognitive impairment (MCI) is a common neurological disorder. This study aims to investigate the modulation effect of Baduanjin (a popular mind-body exercise) on MCI. 69 patients were randomized to Baduanjin, brisk walking, or an education control group for 24 weeks. The Montreal Cognitive Assessment (MoCA) and Magnetic Resonance Imaging scans were applied at baseline and at the end of the experiment. Compared to the brisk walking and control groups, the Baduanjin group experienced significantly increased MoCA scores. Amplitude of low-frequency fluctuations (ALFF) analysis showed significantly decreased ALFF values in the right hippocampus (classic low-freqency band, 0.01‐0.08 Hz) in the Baduanjin group compared to the brisk walking group and increased ALFF values in the bilateral anterior cingulate cortex (ACC, slow-5 band, 0.01-0.027 Hz) in the Baduanjin group compared to the control group. Further, ALFF value changes in the right hippocampus and bilateral ACC were significantly associated with corresponding MoCA score changes across all groups. We also found increased gray matter volume in the Baduanjin group in the right hippocampus compared to the brisk walking group and in the bilateral ACC compared to the control group. In addition, there was an increased resting state functional connectivity between the hippocampus and right angular gyrus in the Baduanjin group compared to the control group. Our results demonstrate the potential of Baduanjin for the treatment of MCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6535682/

Improve Cognitive Function in the Elderly with Mind-Body Practices

February 17, 2020 psyjdc Leave a comment

Improve Cognitive Function in the Elderly with Mind-Body Practices

By John M. de Castro, Ph.D.

“adults with Mild Cognitive Impairment can learn to practice mindfulness meditation, and by doing so may boost their cognitive reserve.” – Rebecca Erwin Wells

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our cognitive (mental) abilities which decline with age including impairments in memory, attention, and problem-solving ability. It is inevitable and cannot be avoided. Research has found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners. Tai Chi and Qigong have also been shown to be beneficial in slowing or delaying physical and mental decline with aging.

The research findings are accumulating suggesting that a summarization of what has been learned is called for. In today’s Research News article “The Effects of Mind-Body Exercise on Cognitive Performance in Elderly: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313783/), Zhang and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled studies (RCTs) of the effectiveness of the mind-body practices of yoga, Tai Chi and Qigong, and Pilates to improve cognitive performance in the elderly (aged 60 and over).

They identified 19 published RCTs that included a total of 2539 participants. They report that the published studies reveal a significant, albeit small, improvement in global cognitive function after mind-body practices. This included significant improvements in executive function, language ability, memory, and visuospatial ability. They also report that the amount of improvement was significantly related to the amount of mind-body exercise training. Interestingly, the effects appear to be better in elderly without any signs of dementia than in those with mild dementia symptoms.

The findings based upon a fair number of well-controlled studies are relatively consistent revealing that mind-body practices are safe and effective in improving cognitive function in individuals over 60 years of age. This suggests that engaging in these practices can reduce the decline in mental abilities occurring with aging. This suggests that engaging in yoga, Tai Chi and Qigong, or Pilates practices should be recommended for people over 60 years of age.

So, improve cognitive function in the elderly with mind-body practices.

“engagement in mindfulness meditation may enhance cognitive performance in older adults, and that with persistent practice, these benefits may be sustained.” – Grace Bullock

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Zhang, Y., Li, C., Zou, L., Liu, X., & Song, W. (2018). The Effects of Mind-Body Exercise on Cognitive Performance in Elderly: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 15(12), 2791. doi:10.3390/ijerph15122791

Abstract

Background: As the situation of cognitive aging is getting worse, preventing or treating cognitive decline through effective strategies is highly important. This systematic review aims to investigate whether mind-body exercise is an effective approach for treating cognition decline. Methods: Searches for the potential studies were performed on the eight electronic databases (MEDLINE, Scopus, Web of Science, SPORTDiscus, CINAHL, PsycArtilces, CNKI, and Wanfang). Randomized controlled trials (RCTs) examining the effect of mind-body exercise on cognitive performance in older adults were included. Data were extracted and effect sizes were pooled with 95% confidence intervals (95% CI) using random-effects models. The Physiotherapy Evidence Database Scale was employed to examine the study quality. Results: Nineteen RCTs including 2539 elders (67.3% female) with fair to good study quality were identified. Mind-body exercise, relative to control intervention, showed significant benefits on cognitive performance, global cognition (Hedges’g = 0.23), executive functions (Hedges’g = 0.25 to 0.65), learning and memory (Hedges’g = 0.37 to 0.49), and language (Hedges’g = 0.35). In addition, no significant adverse events were reported. Conclusion: Mind-body exercise may be a safe and effective intervention for enhancing cognitive function among people aged 60 years or older. Further research evidence is still needed to make a more conclusive statement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313783/

Improve Cardiopulmonary Health Over the Long Haul in Obese Elderly with Tai Chi

February 6, 2020 psyjdc Leave a comment

Improve Cardiopulmonary Health Over the Long Haul in Obese Elderly with Tai Chi

By John M. de Castro, Ph.D.

“Research has found that seniors who regularly practice tai chi are steadier on their feet, less likely to suffer high blood pressure, and physically stronger. Tai chi has been known to improve hand/eye coordination, increase circulation, and can even promote a better night’s sleep.” – Chris Corregall

Obesity is a major risk factor for cardiovascular and pulmonary diseases and diabetes. Overweight and abdominal obesity are associated with high blood pressure, insulin resistance and elevation of plasma cholesterol and triglycerides. It is highly associated with pulmonary problems and type-2 diabetes. Obesity incidence has been rising rapidly and it currently affects over a third of U.S. adults. The simplest treatment is simply exercise and weight loss. Also, mindfulness techniques have been shown to be effective in treating Metabolic Syndrome.

Obviously, there is a need for effective treatments to prevent or treat the health consequences of obesity. But, despite copious research and a myriad of dietary and exercise programs, there still is no safe and effective treatment. Tai Chi practice is both an exercise and a mindfulness practice. It has been found to be effective for an array of physical and psychological issues. It appears to strengthen the immune system, reduce inflammation, and improve cardiovascular function. Tai Chi training has also been shown to improve lung function. These findings are encouraging. But little is known about the ability of Tai Chi practice to improve cardiopulmonary function over the long-term.

In today’s Research News article “Tai Chi can prevent cardiovascular disease and improve cardiopulmonary function of adults with obesity aged 50 years and older: A long-term follow-up study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824704/), Sun and colleagues recruited healthy obese adults over 50 years of age (average 66 years) and provided them with a health education training. In addition, half the participants received training in Tai Chi 3 times per week for 30-40 minutes. They were measured before and after training and then every 3 to 6 months over 6 years for blood pressure, body size, cardiac function, and lung function.

They found that in comparison to baseline and the health education only group, the Tai Chi group had significantly lower systolic and diastolic blood pressure, waist and hip circumference, weight, and body mass index, and significant improvements in cardiac and lung function that were maintained for 6 years. In addition, the Tai Chi group had lower incidences of health complications, lower mortality, and lower rates of cardiovascular and cerebrovascular disease.

These results are exciting and remarkable. It is exceedingly rare to have such long-term follow-up of the effectiveness of an intervention. The results demonstrate that Tai Chi practice can be safely maintained over very long periods of time and produce sustained benefits for the health of the elderly. It’s important to note that Tai Chi is gentle and safe, appropriate for all ages, and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice.

So, improve cardiopulmonary health over the long haul in obese elderly with Tai Chi.

“Practising the ancient martial art of Tai Chi is so beneficial to elderly people’s health that it should be “the preferred mode of training”” – The Telegraph

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Sun, L., Zhuang, L. P., Li, X. Z., Zheng, J., & Wu, W. F. (2019). Tai Chi can prevent cardiovascular disease and improve cardiopulmonary function of adults with obesity aged 50 years and older: A long-term follow-up study. Medicine, 98(42), e17509. doi:10.1097/MD.0000000000017509

Abstract

To research the possible role of Tai Chi in preventing cardiovascular disease and improving cardiopulmonary function in adults with obesity aged 50 years and older.

Between 2007 and 2012, 120 adults with obesity, aged 50 years and older, were divided into a Tai Chi group and a control group, with 60 participants in each group. The 2 groups were evaluated for weight, waist circumference, hip circumference, blood pressure (BP), body mass index, and incidence of chronic disease during follow-up monitoring.

Two- and 6-year follow-up showed that the average BP in the Tai Chi group along with either the systolic or diastolic pressure decreased significantly compared to those in the control group (P < .001). Waist and hip circumference, weight, and body mass index in the Tai Chi group were significantly reduced compared to those in the control group (P < .001). The cardiopulmonary function of the control group and the Tai Chi group changed, with the cardiac index significantly higher in the Tai Chi group than in the control group (P < .05). The Tai Chi group had significantly higher levels of lung function, including vital capacity, maximal oxygen uptake, and total expiratory time, than the control group. The total incidence of complications and mortality in the Tai Chi group were much lower than those in the control group (P < .001). The incidence of cardiovascular and cerebrovascular disease in the Tai Chi group (16.67%) was lower than that in the control group (38.33%).

Tai Chi is not only a suitable exercise for elderly people with obesity, but it can also help to regulate BP, improve heart and lung function in these individuals, as well as reduce the incidence of cardiovascular disease and other chronic diseases, helping to improve their quality of life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824704/

Slow Cellular Aging with Mindfulness

January 27, 2020April 28, 2022 psyjdc Leave a comment

Slow Cellular Aging with Mindfulness

By John M. de Castro, Ph.D.

“those with more years of meditation practice had longer telomere length overall, and that women meditators had significantly longer telomeres as compared to women non-meditators. These findings further support meditation’s positive effect on healthy cellular aging.” – Sonima Wellness

In today’s Research News article “Association among dispositional mindfulness, self-compassion, and leukocyte telomere length in Chinese adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647116/), Keng and colleagues recruited adults, aged 18 to 55 years of age, with no regular meditation or mindfulness practice. Blood samples were drawn and leukocyte telomere length measured. In addition, they were measured for mindfulness, self-compassion, anxiety, depression, and stress.

They found that, as expected, the older the participant the shorter the telomere length and the higher the levels of perceived stress, the shorter the telomere length. When controlling for age they found that the higher the levels of overall mindfulness and the nonreactivity facet of mindfulness the longer the length of the telomeres. Also, when controlling for age the higher the levels of overall self-compassion and the common humanity and de-identification from one’s thoughts and emotions facets of self-compassion the longer the length of the telomeres.

It needs to be kept in mind that these results are correlational and as such causation cannot be determined. However, previous research has demonstrated a causal link by training mindfulness and finding increased telomere lengths. This suggests that the present associations were due to a causal connection between mindfulness and telomere length.

In addition, these were young and middle-aged adults who did not display high levels of mindfulness, stress or psychological distress. Mindfulness is thought to affect telomere length as a result of reducing stress which is responsible for shortening the telomers. So, only mild association would be expected. Clearer larger association may require older more distressed participants. The fact that it was the nonreactivity facet of mindfulness that was most strongly associated with longer telomeres supports the contention that stress reduction is the critical effect of mindfulness. By reducing the reaction to events, stress is lowered which, in turn, decreases cellular aging.

These results suggest that mindfulness, particularly the nonreactivity facet of mindfulness and self-compassion common humanity and de-identification from one’s thoughts and emotions facets of self-compassion reduces cellular aging. Mindfulness increases self-compassion. So, although not tested here, mindfulness may decrease cellular aging both directly and indirectly via self-compassion. By protecting the telomeres from shortening and mindfulness reduces cellular aging. In this way mindfulness may lead to happier and longer lives.

So, slow cellular aging with mindfulness.

“one of the most effective interventions, apparently capable of slowing the erosion of telomeres – and perhaps even lengthening them again – is meditation.” – Jo Marchant

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Keng, S. L., Yim, O. S., Lai, P. S., Chew, S. H., & Ebstein, R. P. (2019). Association among dispositional mindfulness, self-compassion, and leukocyte telomere length in Chinese adults. BMC psychology, 7(1), 47. doi:10.1186/s40359-019-0323-y

Abstract

Background

Whereas meditation training has been purported to support slower cellular aging, little work has explored the association among different facets of dispositional mindfulness, self-compassion, and cellular aging. The present study aimed to examine the relationship between leukocyte telomere length (LTL), an index of cellular aging, dispositional mindfulness, and self-compassion in a sample of Singaporean Chinese adults.

Methods

One hundred and fifty-eight Chinese adults (mean age = 27.24 years; 63.3% female) were recruited from the community and completed self-report measures assessing dispositional mindfulness, self-compassion, and psychological symptoms, as well as provided blood samples for analyses of LTL. Multiple regression analyses were conducted to examine the role of trait mindfulness and self-compassion in predicting LTL, taking into consideration potential covariates such as chronological age and psychological symptoms.

Results

Results showed that nonreactivity, one of the five facets of dispositional mindfulness, was significantly associated with LTL, after controlling for chronological age. There was also a trend for dispositional mindfulness, self-compassion, and their selected facets (i.e., nonjudging, common humanity, and de-identification) to each be associated with longer LTL.

Conclusions

Overall, the findings provide preliminary support for the association among aspects of dispositional mindfulness, self-compassion, and aging. In particular, individuals high on nonreactivity experience slower aging at the cellular level, likely through engaging in more adaptive coping mechanisms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647116/

Improve Quality of Life and Reduce Falls in Dementia Patients with Tai Chi

January 24, 2020 psyjdc Leave a comment

Improve Quality of Life and Reduce Falls in Dementia Patients with Tai Chi

By John M. de Castro, Ph.D.

“The number of people living with Alzheimer’s disease and other dementia-related conditions is exploding in the United States. But while scientists struggle to find a new medical treatment, tai chi, the ancient Chinese martial art, has emerged as a potentially potent way to help stem the tide.” – David-Dorian Ross

Dementia is a progressive loss of mental function produced by degenerative diseases of the brain. These are progressive disorders with no cures. Alzheimer’s disease is the most common form of dementia. It is estimated that 5 million Americans have Alzheimer’s disease. It involves an irreversible progressive loss of mental function associated with brain degeneration. The early stages are typified by memory loss but as the disease progresses patients can lose the ability to carry on a conversation or carry on normal life functions, and eventually leads to death.

Mindfulness training has been found to help protect aging individuals from physical and cognitive declines. Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Tai Chi practice has been found to be effective for an array of physical and psychological issues. Tai Chi has been shown to help the elderly improve attention, balance, reducing falls, arthritis, cognitive function, memory, and reduce age related deterioration of the brain. So, it makes sense to investigate the effects of Tai Chi practice in patients with dementia.

In today’s Research News article “Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875562/),Nyman and colleagues recruited community dwelling elderly (aged 78 to 97 years) adults with dementia and randomly assigned them to either usual care or usual care plus 20 weeks of once a week for 90 minutes Tai Chi practice and home practice. They were measured before and after training for dynamic balance, functional balance, falls, fall efficacy, fear of falls, quality of life, and cognitive function.

They found that in comparison to baseline and the usual care group, the Tai Chi group had a significantly greater quality of life and significantly fewer falls (44% fewer) during the 6-month follow-up period. There were no serious adverse events due to Tai Chi practice recorded.

Since Tai Chi is practiced in groups, the fact that it produced an increase in quality of life may have been due to the enhanced social contacts occurring in the course of practice. This can have quite an impact as community dwelling elderly, and particularly those with dementia, are often isolated from social contacts. The reduced falls has been previous documented in the elderly. The present study, though, documents this in dementia patients. This is very important as falls in the elderly are particularly dangerous and can be major contributors to mortality.

Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to improve the quality of life and prevent falls in elderly dementia patients.

So, improve quality of life and reduce falls in dementia patients with Tai Chi.

“Researchers have shown that regular practice of Tai Chi increases brain volume, augments memory and thinking skills, and may combat dementia.” – Explore

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Samuel R Nyman, Wendy Ingram, Jeanette Sanders, Peter W Thomas, Sarah Thomas, Michael Vassallo, James Raftery, Iram Bibi, Yolanda Barrado-Martín. Randomised Controlled Trial Of The Effect Of Tai Chi On Postural Balance Of People With Dementia. Clin Interv Aging. 2019; 14: 2017–2029. Published online 2019 Nov 19. doi: 10.2147/CIA.S228931

Abstract

Purpose

To investigate the effect of Tai Chi exercise on postural balance among people with dementia (PWD) and the feasibility of a definitive trial on falls prevention.

Patients and methods

Dyads, comprising community-dwelling PWD and their informal carer (N=85), were randomised to usual care (n=43) or usual care plus weekly Tai Chi classes and home practice for 20 weeks (n=42). The primary outcome was the timed up and go test. All outcomes for PWD and their carers were assessed six months post-baseline, except for falls, which were collected prospectively over the six-month follow-up period.

Results

For PWD, there was no significant difference at follow-up on the timed up and go test (mean difference [MD] = 0.82, 95% confidence interval [CI] = −2.17, 3.81). At follow-up, PWD in the Tai Chi group had significantly higher quality of life (MD = 0.051, 95% CI = 0.002, 0.100, standardised effect size [ES] = 0.51) and a significantly lower rate of falls (rate ratio = 0.35, 95% CI =0.15, 0.81), which was no longer significant when an outlier was removed. Carers in the Tai Chi group at follow-up were significantly worse on the timed up and go test (MD = 1.83, 95% CI = 0.12, 3.53, ES = 0.61). The remaining secondary outcomes were not significant. No serious adverse events were related to participation in Tai Chi.

Conclusion

With refinement, this Tai Chi intervention has potential to reduce the incidence of falls and improve quality of life among community-dwelling PWD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875562/

Reduce Pain and Falls and Improve Mobility in the Elderly with Tai Chi

December 18, 2019 psyjdc Leave a comment

Reduce Pain and Falls and Improve Mobility in the Elderly with Tai Chi

By John M. de Castro, Ph.D.

“Solid research shows that tai chi can benefit people with osteoarthritis, rheumatoid arthritis, fibromyalgia, tension headache, and other ongoing, painful conditions.” – Harvard Health

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the body to prevent or relieve pain. Psychologically, the stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Tai Chi, Qigong, and yoga are all exercises and mindfulness practices that have been found to be effective for pain.

In today’s Research News article “Tai Chi for older adults with chronic multisite pain: a randomized controlled pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126990/), You and colleagues examine the ability of Tai Chi practice to reduce chronic pain in the elderly. They recruited elderly (>65 years of age) with multisite (2 or more) musculoskeletal pain who either had 1 or more falls in the last year or used a cane or walker. They were randomly assigned to receive 12 weeks, 2 hours, twice a week of either Tai Chi or light physical exercise. They were measured before and after training for acceptability of the exercises, chronic health conditions, pain, attention, executive function, physical function, gait, falls, and fear of falling. 83% of the elderly completed the study.

They found that in comparison to baseline the elderly who engaged in Tai Chi had significantly lower pain and pain interference with activities, improvements in gait, including stride and swing time, and decreased gait asymmetry, and decreased fear of falling, and fewer falls over the subsequent 9 months, while the light exercise group did not.

These are encouraging pilot results that are similar to other findings with Tai Chi with other types of patients. Unfortunately, because this was a small pilot study there were no statistically significant differences between the Tai Chi group and the light exercise group even though the Tai Chi groups was significantly improved relative to baseline whereas the light exercise group was not. But these results provide justification for performing a future large scale randomized controlled trial.

It’s important to note that Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice.

So, reduce pain and falls and improve mobility in the elderly with Tai Chi.

“Improved flexibility will reduce stiffness and help keep joints mobile. Stiffness causes pain; increase flexibility will relieve pain. Tai Chi for Arthritis gently moves all joints, muscles and tendons throughout the body.” – Paul Lam

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

You, T., Ogawa, E. F., Thapa, S., Cai, Y., Zhang, H., Nagae, S., … Leveille, S. G. (2018). Tai Chi for older adults with chronic multisite pain: a randomized controlled pilot study. Aging clinical and experimental research, 30(11), 1335–1343. doi:10.1007/s40520-018-0922-0

Abstract

Background

Chronic pain is associated with poorer cognition and mobility, and fall risk in older adults.

Aims

To investigate the feasibility of a randomized trial of mind-body exercise (Tai Chi) versus light physical exercise in older adults with multisite pain.

Methods

Adults aged ≥ 65y with multisite pain who reported falling in the past year or current use of an assistive device were recruited from Boston area communities. Participants were randomized to either a Tai Chi or a light physical exercise program, offered twice weekly for 12 weeks. The primary outcomes were feasibility and acceptability. Secondary outcomes included pain characteristics, cognition, physical function, gait mobility, fear of falling, and fall frequency.

Results

Of 176 adults screened, 85 were eligible, and 54 consented and enrolled (average age 75±8y; 96.30% white; 75.93% female). The dropout rate was 18% for Tai Chi and 12% for light physical exercise. For those completing the study, exercise class attendance was 76% for Tai Chi and 82% for light physical exercise. There were no significant group differences in most secondary outcomes. Tai Chi significantly lowered pain severity (4.58±1.73 to 3.73±1.79, p<0.01) and pain interference (4.20±2.53 to 3.16±2.28, p<0.05), reduced fear of falling (90.82±9.59 to 96.84±10.67, p<0.05), and improved several single-task and dual-task gait variables, while light physical exercise did not change these measures

Discussion and Conclusions

This study demonstrated the feasibility and acceptability of conducting a larger randomized controlled trial in older adults with multisite pain. Study findings and challenges encountered will inform future research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126990/