Mild cognitive impairment negatively impacts cognition and dual-task abilities. A physical-cognitive integrated treatment approach could mitigate this risk for dementia.
Scientists from several institutes in Oregoncompared the effectiveness of cognitively enhanced Tai Chi versus standard Tai Chi or stretching exercise in improving global cognition and reducing dual-task walking costs in older adults with mild cognitive impairment or self-reported memory concerns.
The team recruited 318 older adults with self-reported memory decline or concern and a Clinical Dementia Rating (CDR) global score of 0.5 or lower at baseline. The participants were almost evenly assigned to one of the 3 groups: cognitively enhanced Tai Chi, standard Tai Chi, and stretching. All groups exercised at home via real-time videoconferencing, 1 hour semiweekly for 24 weeks.
The co-primary endpoints were changed in Montreal Cognitive Assessment and dual-task walking costs (difference between single- and dual-task gait speed, expressed in percentage) from baseline to 24 weeks. Secondary outcomes included CDR-Sum of Boxes (CDR-SB), Trail Making Test B, Digit Span Backward (DSB), and physical performance tests. Outcomes were assessed at 16, 24 (primary endpoint), and 48 weeks (6 months after intervention).
A total of 304 participants (96%) completed the 24-week assessment. Cognitively enhanced Tai Chi outperformed standard Tai Chi and stretching with a greater improvement in MoCA score and in dual-task walking. The intervention effects persisted at 48-week follow-up.
Among community-dwelling older adults with mild cognitive impairment, cognitively enriched Tai Chi therapy was superior to standard Tai Chi and stretching exercise in improving global cognition and reducing dual-task gait interference, with outcomes sustained at 48 weeks.
The findings are published by Annals of internal medicine in its November 2023 issue.
