Tai chi improves cognitive function in adults with type 2 diabetes

Key takeaways:

• Tai chi was better than walking for promoting brain health among adults with mild cognitive impairment and type 2 diabetes.
• There were significant differences between the activities at 36 weeks.

Among older adults with type 2 diabetes and mild cognitive impairment, tai chi conferred more benefits than walking in improving global cognitive function, according to researchers, highlighting the activity’s clinical potential.

“Type 2 diabetes and cognitive dysfunction are highly prevalent and frequently coexist in older adults,” Yannan Chen, PhD, of Fujian University of Traditional Chinese Medicine’s College of Rehabilitation Medicine in Fuzhou, China, and colleagues wrote in JAMA Network Open. “Cognitive dysfunction is now accepted as an important and common comorbidity or even complication of diabetes.”

The prevalence of mild cognitive impairment (MCI) among individuals with type 2 diabetes has been estimated to be as high as 45%, according to Chen and colleagues.

Previous research has indicated that physical activity offers benefits for cognition, they added, and tai chi chuan has become an increasingly popular multimodal mind-body exercise thought to promote brain health. However, no studies have shown whether tai chi chuan has better long-term benefits than walking for patients with type 2 diabetes and MCI.

So, Chen and colleagues conducted a randomized clinical trial to compare the effects of the two activities at four sites in China. The study included 328 adults aged 60 years or older, 50.9% of whom were women and all of whom had clinical diagnoses of type 2 diabetes and MCI.

The participants were randomly assigned in a 1:1:1 ratio to a tai chi chuan group, which consisted of 24-form simplified tai chi chuan, a fitness walking group or a control group. In all, 107 were in the tai chi group, 110 were in the walking group and 111 were in the control group.

Both the exercise groups underwent training for an hour-long session three times a week for 24 weeks. All three groups additionally received a 30-minute diabetes self-management education session once every 4 weeks for 24 weeks.

At 24 weeks, both the tai chi chuan and fitness walking groups saw improved Montreal Cognitive Assessment (MoCA) scores compared with the control group. The treatment effects were similar in each group once the researchers adjusted for self-reported dietary calories and physical activity, based on the generalized linear models.

“Although there was no significant difference in MoCA scores between the tai chi chuan and fitness walking groups at 24 weeks, the mean changes in the tai chi chuan group were greater than in the fitness walking group,” the researchers wrote.

However, in an intention-to-treat analysis, the researchers found that, at a 36-week follow up, the tai chi chuan group had better MoCA scores (ranging from 0 to 30) than the fitness walking group: 24.67 vs. 23.84, with a between-group mean difference of 0.84 (95% CI, 0.02-1.66).

“Because tai chi chuan is a mind-body exercise that requires constant memorization and learning of movements, it took longer for patients to achieve better performance, which might be an important reason why the significant differences were found at 36 rather than 24 weeks,” the researchers wrote.

Chen and colleagues concluded that their findings “support a long-term benefit of tai chi chuan in strengthening cognitive function, supporting the clinical application of tai chi chuan as an exercise intervention to promote cognitive function for older adults with type 2 diabetes and MCI.”