Effects of Chinese Mind-Body Exercises on Executive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis

Abstract

Chinese mind-body exercises (CMBEs) are positively associated with executive function (EF), but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through June 2020 (PubMed, Web of Science, Embase, Cochrane Controlled Trials Register, Wanfang, China National Knowledge Infrastructure, and Weipu). Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment (MCI) and with or without chronic diseases were included. A total of 29 studies (N = 2,934) ultimately were included in this study. The results indicated that CMBEs improved overall EF (Standardized Mean Differences = 0.28, 95% CI 0.12, 0.44), as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type (Tai Chi, Qigong), frequency of group classes (≤2 time, 3-4 time, ≥5 times), session time (≤45 min, 46-60 min), total training time (≥150 to ≤300 min, >300 min), and length of the CMBEs (4-12 week, 13-26 week, and >26 week), in addition to that more frequent participation in both group classes and home practice sessions (≥5 times per week) resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age (50-65 years old, >65 years old), sex (only female, both), and cognitive statuses (normal, MCI, not mentioned), health status (with chronic disease, without chronic disease), as well as training mode (group class, group class plus home practice) and study language (English, Chinese). This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES (effect size) samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF.

The Effects of Tai Chi on the Executive Functions and Physical Fitness in Middle-Aged Adults with Depression: A Randomized Controlled Trial

“…Furthermore, consistent with the findings of previous meta-analyses on the effects of Tai Chi on executive function [ 46 , 67 ] a higher post-test total correct score signifies that the Tai Chi intervention can improve working memory. Even though previous empirical results support the effectiveness of long-term aerobic exercise on working memory [ 79 ], a recent meta-analysis of 25 RCT studies showed that Tai Chi-centered mind-body exercises can improve working memory more efficiently [ 72 ].…”

“…Sungkarat et al [ 78 ] found that even though the Tai Chi intervention benefits general memory and conversion, it does not improve planning-related outcomes. Therefore, future studies should explore the effects of Tai Chi on planning-related executive functions to compensate for the existing shortcomings in the research [ 46 , 67 ].…”

The Effectiveness of Traditional Chinese Yijinjing Qigong Exercise for the Patients With Knee Osteoarthritis on the Pain, Dysfunction, and Mood Disorder: A Pilot Randomized Controlled Trial

“…Evidence of systematic review for Qigong has shown to improve depression (27,28), and this study provided corresponding evidence for YJJQE. This finding might benefit from the fact that psychosomatic therapy has the dual mechanism of exercise and meditation that can relieve KOA pain and mood disorders (29,30). The underlying mechanism that physical exercise, combined with continuous cognitive challenge training, can maintain a new neuron pool experiences, more complex cognitive tasks, and even recruits new neurons to improve brain function (31).…”

Training Willpower: Reducing Costs and Valuing Effort

“…Fifteen out the 63 meta-analyses included in the present systematic review considered the type of control group as a moderator of the effect size of the intervention. Five out of these 15 meta-analyses showed that the effect size was significantly larger for studies that used a passive control group rather than an active one ( Karr et al, 2014 ; Beames et al, 2018 ; Northey et al, 2018 ; Nguyen et al, 2019 ; Ren et al, 2021 ).…”