Tai chi improves psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic

Rima Solianik, Dalia Mickevičienė, Laura Žlibinaitė, Agnė Čekanauskaitė, Rima Solianik, Dalia Mickevičienė, Laura Žlibinaitė, Agnė Čekanauskaitė

Abstract

The aim of this study was to determine the effect of a 10-week tai chi intervention on psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic. Participants aged 60-78 years were randomized to either a control group (n = 15) or a tai chi group (n = 15) for a 10-week period. The tai chi group received two, 8-form tai chi classes of 60 min duration per week. Changes in psychoemotional state, cognition, and the learning of fast and accurate reaching movements were assessed. In addition, the potential roles of the autonomic nervous system and brain-derived neurotrophic factor (BDNF) were investigated. Tai chi practice decreased (P < 0.05) perceived stress, whereas no change in autonomic nervous system activity was observed. Improvements in mental switching correlated with decreased depressive symptoms and increased BDNF levels (P < 0.05), whereas improvements in inhibitory control tended to correlate with BDNF levels (P = 0.08). Improvements in visuospatial processing tended to correlate with decreased depressive symptoms (P = 0.07) while improved visuospatial processing correlated with improved motor planning during learning tasks (P < 0.05). This study suggests that tai chi is an effective intervention that can be delivered under pandemic conditions to improve mental and physical function in older adults.

Keywords: BDNF; Cognitive function; Depression; Heart rate variability; Motor function; Stress.

Conflict of interest statement

None.

Copyright © 2021 Elsevier Inc. All rights reserved.

Figures

Fig. 1
Fig. 1
CONSORT flow chart of the study.
Fig. 2
Fig. 2
The effect of tai chi on the brain-derived neurotrophic factor (BDNF) level. Values are given as mean (standard deviation). aP < 0.05, time effect; axbP < 0.05, time × group interaction effect; *P < 0.05, compared with before; #P < 0.05, compared with tai chi group.
Fig. 3
Fig. 3
The effect of tai chi on motor learning. Values are given as mean (standard deviation). aP < 0.05, time effect; axbP < 0.05, time × group interaction effect; *P < 0.05, compared with the baseline (0 block), #P < 0.05, compared with control group.

References

    1. Aggarwal N.T., Wilson R.S., Beck T.L., Rajan K.B., Mendes de Leon C.F., Evans D.A., Everson-Rose S.A. Perceived stress and change in cognitive function among adults aged 65 and older. Psychosom. Med. 2014;76(1):80–85. doi: 10.1097/PSY.0000000000000016.
    1. Aminoff E.M., Kveraga K., Bar M. The role of the parahippocampal cortex in cognition. Trends Cogn. Sci. 2013;17(8):379–390. doi: 10.1016/j.tics.2013.06.009.
    1. Aronow W.S. Blood pressure goals and targets in the elderly. Curr. Treat. Option Cardiovasc. Med. 2015;17(7):394. doi: 10.1007/s11936-015-0394-x.
    1. Audette J.F., Jin Y.S., Newcomer R., Stein L., Duncan G., Frontera W.R. Tai chi versus brisk walking in elderly women. Age Ageing. 2006;35(4):388–393. doi: 10.1093/ageing/afl006.
    1. Bolmont B. Causes, Role and Influence of Mood States. Nova Biomedical Books; 2005. Role and influence of moods including anxiety on motor control; pp. 57–73.
    1. Buyukdura J.S., McClintock S.M., Croarkin P.E. Psychomotor retardation in depression: biological underpinnings, measurement, and treatment. Prog. Neuro-Psychopharmacol. Biol. Psychiatry. 2011;35(2):395–409. doi: 10.1016/j.pnpbp.2010.10.019.
    1. Čekanauskaitė A., Skurvydas A., Žlibinaitė L., Mickevičienė D., Kilikevičienė S., Solianik R. A 10-week yoga practice has no effect on cognition, but improves balance and motor learning by attenuating brain-derived neurotrophic factor levels in older adults. Exp. Gerontol. 2020;138 doi: 10.1016/j.exger.2020.110998.
    1. Chan A.W.K., Chair S.Y., Lee D.T.F., Leung D.Y.P., Sit J.W.H., Cheng H.Y., Taylor-Piliae R.E. Tai chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: a randomised controlled trial. Int. J. Nurs. Stud. 2018;88:44–52. doi: 10.1016/j.ijnurstu.2018.08.009.
    1. Chang Y.-K., Nien Y.-H., Tsai C.-L., Etnier J.L. Physical activity and cognition in older adults: the potential of Tai Chi Chuan. J. Aging Phys. Act. 2010;18(4):451–472. doi: 10.1123/japa.18.4.451.
    1. Cho K.-L. Effect of tai chi on depressive symptoms amongst Chinese older patients with major depression: the role of social support. Med. Sport Sci. 2008;52:146–154. doi: 10.1159/000134295.
    1. Chow G.V., Marine J.E., Fleg J.L. Epidemiology of arrhythmias and conduction disorders in older adults. Clin. Geriatr. Med. 2012;28(4):539–553. doi: 10.1016/j.cger.2012.07.003.
    1. Cohen S., Kamarck T., Mermelstein R. A global measure of perceived stress. J. Health Soc. Behav. 1983;24(4):385–396.
    1. Delmas S., Casamento-Moran A., Park S.H., Yacoubi B., Christou E.A. Motor planning perturbation: muscle activation and reaction time. J. Neurophysiol. 2018;120(4):2059–2065. doi: 10.1152/jn.00323.2018.
    1. Duman R.S., Deyama S., Fogaça M.V. Role of BDNF in the pathophysiology and treatment of depression: activity-dependent effects distinguish rapid-acting antidepressants. Eur. J. Neurosci. 2019;53(1):126–139. doi: 10.1111/ejn.14630.
    1. Erickson K.I., Voss M.W., Prakash R.S., Basak C., Szabo A., Chaddock L., Kim J.S., Heo S., Alves H., White S.M., Wojcicki T.R., Mailey E., Vieira V.J., Martin S.A., Pence B.D., Woods J.A., McAuley E., Kramer A.F. Exercise training increases size of hippocampus and improves memory. Proc. Natl. Acad. Sci. U. S. A. 2011;108(7):3017–3022. doi: 10.1073/pnas.1015950108.
    1. Flesia L., Monaro M., Mazza C., Fietta V., Colicino E., Segatto B., Roma P. Predicting perceived stress related to the COVID-19 outbreak through stable psychological traits and machine learning models. J. Clin. Med. 2020;9(10):3350. doi: 10.3390/jcm9103350.
    1. Folstein M.F., Folstein S.E., McHugh P.R. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 1975;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6.
    1. Gheysen F., Poppe L., DeSmet A., Swinnen S., Cardon G., De Bourdeaudhuij I., Chastin S., Fias W. Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis. Int. J. Behav. Nutr. Phys. Act. 2018;15 doi: 10.1186/s12966-018-0697-x.
    1. Harada C.N., Natelson Love M.C., Triebel K. Normal cognitive aging. Clin. Geriatr. Med. 2013;29(4):737–752. doi: 10.1016/j.cger.2013.07.002.
    1. Holmes E.A., O'Connor R.C., Perry V.H., Tracey I., Wessely S., Arseneault L., Ballard C., Christensen H., Silver R.C., Everall I., Ford T., John A., Kabir T., King K., Madan I., Michie S., Przybylski A.K., Shafran R., Sweeney A.…Bullmore E. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry. 2020;7(6):547–560. doi: 10.1016/S2215-0366(20)30168-1.
    1. Kim D.H., Lipsitz L.A., Ferrucci L., Varadhan R., Guralnik J.M., Carlson M.C., Fleisher L.A., Fried L.P., Chaves P.H.M. Association between reduced heart rate variability and cognitive impairment in older disabled women in the community: women’s health and aging study I. J. Am. Geriatr. Soc. 2006;54(11):1751–1757. doi: 10.1111/j.1532-5415.2006.00940.x.
    1. Kim H.-G., Cheon E.-J., Bai D.-S., Lee Y.H., Koo B.-H. Stress and heart rate variability: a meta-analysis and review of the literature. Psychiatry Investig. 2018;15(3):235–245. doi: 10.30773/pi.2017.08.17.
    1. Krishnan C., Washabaugh E.P., Reid C.E., Althoen M.M., Ranganathan R. Learning new gait patterns: age-related differences in skill acquisition and interlimb transfer. Exp. Gerontol. 2018;111:45–52. doi: 10.1016/j.exger.2018.07.001.
    1. Kwag K.H., Martin P., Russell D., Franke W., Kohut M. The impact of perceived stress, social support, and home-based physical activity on mental health among older adults. Int. J. Aging Hum. Dev. 2011;72(2):137–154. doi: 10.2190/AG.72.2.c.
    1. Lee Y.M. The effects of tai chi on waist circumference and blood pressure in the elderly. J. Phys. Ther. Sci. 2017;29(1):172–175. doi: 10.1589/jpts.29.172.
    1. Lee K.Y.T., Hui-Chan C.W.Y., Tsang W.W.N. The effects of practicing sitting tai chi on balance control and eye-hand coordination in the older adults: a randomized controlled trial. Disabil. Rehabil. 2015;37(9):790–794. doi: 10.3109/09638288.2014.942003.
    1. Levin O., Netz Y. Aerobic training as a means to enhance inhibition: what’s yet to be studied? Eur. Rev. Aging Phys. Act. 2015;12 doi: 10.1186/s11556-015-0160-9.
    1. Li F., Harmer P., Liu Y., Chou L.-S. Tai ji quan and global cognitive function in older adults with cognitive impairment: a pilot study. Arch. Gerontol. Geriatr. 2014;58(3):434–439. doi: 10.1016/j.archger.2013.12.003.
    1. Lingo Van Gilder J., Hengge C.R., Duff K., Schaefer S.Y. Visuospatial function predicts one-week motor skill retention in cognitively intact older adults. Neurosci. Lett. 2018;664:139–143. doi: 10.1016/j.neulet.2017.11.032.
    1. Lu X., Siu K.C., Fu S.N., Hui-Chan C.W.Y., Tsang W.W.N. Effects of tai chi training on postural control and cognitive performance while dual tasking—a randomized clinical trial. J. Complement. Integrat. Med. 2016;13(2):181–187. doi: 10.1515/jcim-2015-0084.
    1. Mang C.S., Campbell K.L., Ross C.J.D., Boyd L.A. Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Phys. Ther. 2013;93(12):1707–1716. doi: 10.2522/ptj.20130053.
    1. Meyers J.E., Vincent A.S. Automated neuropsychological assessment metrics (v4) military battery: military normative data. Mil. Med. 2020;185(9–10):e1706–e1721. doi: 10.1093/milmed/usaa066.
    1. Mondal A.C., Fatima M. Direct and indirect evidences of BDNF and NGF as key modulators in depression: role of antidepressants treatment. Int. J. Neurosci. 2019;129(3):283–296. doi: 10.1080/00207454.2018.1527328.
    1. Pan Z., Su X., Fang Q., Hou L., Lee Y., Chen C.C., Lamberth J., Kim M.-L. The effects of tai chi intervention on healthy elderly by means of neuroimaging and EEG: a systematic review. Front. Aging Neurosci. 2018;10 doi: 10.3389/fnagi.2018.00110.
    1. Perini G., Cotta Ramusino M., Sinforiani E., Bernini S., Petrachi R., Costa A. Cognitive impairment in depression: recent advances and novel treatments. Neuropsychiatr. Dis. Treat. 2019;15:1249–1258. doi: 10.2147/NDT.S199746.
    1. Phillips C. Brain-derived neurotrophic factor, depression, and physical activity: making the neuroplastic connection. Neural Plasticity. 2017;2017 doi: 10.1155/2017/7260130.
    1. Reeves D.L., Winter K.P., Bleiberg J., Kane R.L. ANAM genogram: historical perspectives, description, and current endeavors. Arch. Clin. Neuropsychol. 2007;22(Suppl. 1):S15–S37. doi: 10.1016/j.acn.2006.10.013.
    1. Ren J., Wu Y.D., Chan J.S.Y., Yan J.H. Cognitive aging affects motor performance and learning. Geriatr Gerontol Int. 2013;13(1):19–27. doi: 10.1111/j.1447-0594.2012.00914.x.
    1. Riegle van West K., Stinear C., Buck R. The effects of poi on physical and cognitive function in healthy older adults. J. Aging Phys. Act. 2018:1–9. doi: 10.1123/japa.2017-0273.
    1. Rosenkranz K., Rothwell J.C. Modulation of proprioceptive integration in the motor cortex shapes human motor learning. J. Neurosci. 2012;32(26):9000–9006. doi: 10.1523/JNEUROSCI.0120-12.2012.
    1. Schaefer S.Y., Duff K. Within-session and one-week practice effects on a motor task in amnestic mild cognitive impairment. J. Clin. Exp. Neuropsychol. 2017;39(5):473–484. doi: 10.1080/13803395.2016.1236905.
    1. Seidler R.D., Bernard J.A., Burutolu T.B., Fling B.W., Gordon M.T., Gwin J.T., Kwak Y., Lipps D.B. Motor control and aging: links to age-related brain structural, functional, and biochemical effects. Neurosci. Biobehav. Rev. 2010;34(5):721–733. doi: 10.1016/j.neubiorev.2009.10.005.
    1. Shaffer F., Ginsberg J.P. An overview of heart rate variability metrics and norms. Front. Public Health. 2017;5:258. doi: 10.3389/fpubh.2017.00258.
    1. Shimada H., Makizako H., Doi T., Yoshida D., Tsutsumimoto K., Anan Y., Uemura K., Lee S., Park H., Suzuki T. A large, cross-sectional observational study of serum BDNF, cognitive function, and mild cognitive impairment in the elderly. Front. Aging Neurosci. 2014;6 doi: 10.3389/fnagi.2014.00069.
    1. Snaith R.P. The hospital anxiety and depression scale. Health Qual. Life Outcomes. 2003;1:29. doi: 10.1186/1477-7525-1-29.
    1. Solianik R., Sujeta A. Two-day fasting evokes stress, but does not affect mood, brain activity, cognitive, psychomotor, and motor performance in overweight women. Behav. Brain Res. 2018;338:166–172. doi: 10.1016/j.bbr.2017.10.028.
    1. Solianik R., Sujeta A., Čekanauskaitė A. Effects of 2-day calorie restriction on cardiovascular autonomic response, mood, and cognitive and motor functions in obese young adult women. Exp. Brain Res. 2018;236(8):2299–2308. doi: 10.1007/s00221-018-5305-4.
    1. Sungkarat S., Boripuntakul S., Chattipakorn N., Watcharasaksilp K., Lord S.R. Effects of tai chi on cognition and fall risk in older adults with mild cognitive impairment: a randomized controlled trial. J. Am. Geriatr. Soc. 2017;65(4):721–727. doi: 10.1111/jgs.14594.
    1. Sungkarat S., Boripuntakul S., Kumfu S., Lord S.R., Chattipakorn N. Tai chi improves cognition and plasma BDNF in older adults with mild cognitive impairment: a randomized controlled trial. Neurorehabil. Neural Repair. 2018;32(2):142–149. doi: 10.1177/1545968317753682.
    1. Tao J., Chen X., Liu J., Egorova N., Xue X., Liu W., Zheng G., Li M., Wu J., Hu K., Wang Z., Chen L., Kong J. Tai chi chuan and baduanjin mind-body training changes resting-state low-frequency fluctuations in the frontal lobe of older adults: a resting-state fMRI study. Front. Hum. Neurosci. 2017;11 doi: 10.3389/fnhum.2017.00514.
    1. Tao J., Liu J., Liu W., Huang J., Xue X., Chen X., Wu J., Zheng G., Chen B., Li M., Sun S., Jorgenson K., Lang C., Hu K., Chen S., Chen L., Kong J. Tai chi chuan and baduanjin increase grey matter volume in older adults: a brain imaging study. J. Alzheimer's Dis. 2017;60(2):389–400. doi: 10.3233/JAD-170477.
    1. Taylor-Piliae R.E., Haskell W.L., Waters C.M., Froelicher E.S. Change in perceived psychosocial status following a 12-week tai chi exercise programme. J. Adv. Nurs. 2006;54(3):313–329. doi: 10.1111/j.1365-2648.2006.03809.x.
    1. Tschanz J.T., Pfister R., Wanzek J., Corcoran C., Smith K., Tschanz B.T., Steffens D.C., Østbye T., Welsh-Bohmer K.A., Norton M.C. Stressful life events and cognitive decline in late life: moderation by education and age. The Cache County study. Int. J. Geriat. Psych. 2013;28(8):821–830. doi: 10.1002/gps.3888.
    1. Wang C., Pan R., Wan X., Tan Y., Xu L., Ho C.S., Ho R.C. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health. 2020;17(5):1729. doi: 10.3390/ijerph17051729.
    1. Whitehead B.R. COVID-19 as a stressor: pandemic expectations, perceived stress, and negative affect in older adults. J. Gerontol. Series B. 2020;76(2):e59–e64. doi: 10.1093/geronb/gbaa153.
    1. Won E., Kim Y.-K. Stress, the autonomic nervous system, and the immune-kynurenine pathway in the etiology of depression. Curr. Neuropharmacol. 2016;14(7):665–673. doi: 10.2174/1570159x14666151208113006.
    1. World Health Organization. (2020). Timeline of WHO's response to COVID-19. .
    1. Wu Q., Chan J.S.Y., Yan J.H. Mild cognitive impairment affects motor control and skill learning. Rev. Neurosci. 2016;27(2):197–217. doi: 10.1515/revneuro-2015-0020.
    1. Wu M.-T., Tang P.-F., Goh J.O.S., Chou T.-L., Chang Y.-K., Hsu Y.-C., Chen Y.-J., Chen N.-C., Tseng W.-Y.I., Gau S.S.-F., Chiu M.-J., Lan C. Task-switching performance improvements after tai chi chuan training are associated with greater prefrontal activation in older adults. Front. Aging Neurosci. 2018;10 doi: 10.3389/fnagi.2018.00280.
    1. Yan J.H. Tai chi practice improves senior citizens’ balance and arm movement control. J. Aging Phys. Act. 1998;6(3):271–284. doi: 10.1123/japa.6.3.271.
    1. Yang Y., Chen T., Shao M., Yan S., Yue G.H., Jiang C. Effects of tai chi chuan on inhibitory control in elderly women: an fNIRS study. Front. Hum. Neurosci. 2020;13 doi: 10.3389/fnhum.2019.00476.
    1. Yao H., Chen J.-H., Xu Y.-F. Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4) doi: 10.1016/S2215-0366(20)30090-0.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する