Effects of Tai Chi Chuan on Cognitive Function in Older Adults with Cognitive Impairment: A Systematic and Meta‐Analytic Review

Abstract

This systematic and meta-analytic review aimed to investigate the effects of Tai Chi Chuan (TCC) on the cognitive function of the elderly with cognitive impairment and to analyze the moderators of these effects. We searched eight electronic databases for randomized controlled trials on the effects of TCC on cognitive function, published up to June 14, 2020. The PEDro scale was used to evaluate the methodological quality of the included literature. Stata14.0 software was used for meta-analysis, subgroup analysis, and publication bias testing. A total of 19 studies and 1,970 samples were included. The methodological quality of the included literature was fair to good, and there was no publication bias. Overall, the research shows that the effect of TCC on the elderly with cognitive impairment is statistically significant (SMD = 0.31, p < 0.0001 ). Five of the cognitive function subdomains were significant moderators [Q (5) = 15.66, p = 0.008 ], and the effect size (ES) was the largest for global cognitive function (SMD = 0.41), followed by executive function (SMD = 0.33), memory (SMD = 0.31), and verbal fluency (SMD = 0.27). Regarding the exercise prescription variables, results were significantly moderated by the length of exercise training [Q (2) = 6.00, p = 0.05 ], with ESs largest for moderate length (SMD = 0.41), followed by short length (SMD = 0.40) and long length (SMD = 0.29). However, the results were not moderated by session time or frequency. TCC can improve multiple cognitive functions of the elderly with cognitive impairment. The intervention effects are moderated by exercise length, but not by exercise session time and frequency.

Evidence Quality Assessment of Tai Chi Exercise Intervention in Cognitive Impairment: An Overview of Systematic Review and Meta-Analysis

“…The characteristics included in the overview are shown in Table 2 . These SRs/MAs were all published between 2017 and 2021, 5 [ 27 – 31 ] of which were in English, and the remaining 3 [ 32 – 34 ] were in Chinese, and all were written by Chinese authors. The number of RCTs was between 3 and 19, and the sample size was between 378 and 1,970.…”

“…The number of RCTs was between 3 and 19, and the sample size was between 378 and 1,970. In 5 SRs/MAs [ 27 – 31 ], the intervention method for the control group was CT or daily life activities, while that for the experimental group was TC or TC combined with the intervention methods for the control group. In 3 SRs/MAs [ 32 – 34 ], the intervention method for the control group was CT or daily life activities, while that for the experimental group was TC exercise.…”

“…In 3 SRs/MAs [ 32 – 34 ], the intervention method for the control group was CT or daily life activities, while that for the experimental group was TC exercise. In terms of quality evaluation scales, 6 SRs/MAs [ 27 , 29 , 30 , 32 – 34 ] used the Cochrane risk of bias standard, and 2 SRs/MAs [ 28 , 31 ] used the Physiotherapy Evidence Database scale.…”

“…By using AMSTAR-2 to assess the methodological quality, all SRs/MAs were considered to be of very low quality because more than one key item was missing from the included SRs/MAs. The restrictions came from the following items: Item 2 (only 2 SRs/MAs [ 29 , 30 ] have registered protocol), Item 7 (the list of excluded studies was not mentioned by any SR/MA), Item 10 (none reported the funding of RCTs included in SRs/MAs), and Item 15 (only one SR/MA [ 31 ] conducted publication bias assessment or discussed their impact on SR/MA). The AMSTAR-2 assessment breakdown for each SR/MA is shown in Table 3 .…”

“…In Phase 2, Domain 1, all SRs/MAs were rated as low risk of bias. In Domain 2, 5 SRs/MAs [ 27 , 28 , 30 , 31 , 34 ] were rated as low risk. In Domain 3, 6 SRs/MAs [ 27 , 28 , 31 – 34 ] of which were rated as low risk of bias, and none of one SR/MA was rated as low risk of bias in Domain 4.…”