Dementia includes a variety of cognitive impairments often associated with advanced aging. Individuals
who have it have difficulty performing normal cognitive functions. Tai chi and qigong are forms of
traditional Chinese medicine (TCM) that are being used to treat various kinds of dementia. This article
summarizes some recent studies on the use of tai chi and qigong on patients suffering from dementia.
Several studies have found that the use of tai chi or qigong have been significantly more beneficial in
slowing down or even reversing mental decline when compared to the control group.
Keywords: Tai Chi; Qigong; Traditional Chinese Medicine; TCM; Dementia; Alzheimer’s Disease; Cognitive Impairment
Abbreviations: TCM: Traditional Chinese Medicine; CDR: Clinical Dementia Rating; MoCA: Montreal Cognitive Assessment; CDR-SB: CDR-Sum of Boxes; TUG: Timed Up and Go; GDS: Geriatric Depression
Scale; AMCI: Mild Cognitive Impairment; TDCS: Transcranial Direct Current Stimulation
Tai chi [1-5] and qigong [6-71] [pronounced chee gong or chee
kung] are ancient forms of traditional Chinese medicine (TCM). They
are both mind-body practices that involve breathing, mindfulness,
meditation and a variety of slow, gentle movements. One might reasonably
say that all tai chi includes qigong when practiced correctly,
but not all qigong is tai chi. Tai chi originated as a martial art, but in
recent years its focus has shifted more toward health benefits. Qigong
is not considered a martial art. There is no need to go into the nuances
between these two tools of traditional Chinese medicine except
to say that qigong is easier to learn than tai chi. Both have been effective
in treating Parkinson’s disease [72], cancer [73-82], cognitive
impairment [83-92] and a wide range of other ailments [93-101]. The
purpose of the present article is to summarize and discuss how tai chi
and qigong are being used to treat patients with dementia.
The internet and the PubMed [102] database were used to search
for recent studies involving tai chi or qigong in the treatment of dementia.
A recent study conducted in the United States [103,104] compared
the effectiveness of stretching exercises (n = 106), standard tai
chi (n = 107) and cognitively enhanced tai chi (n = 105) on improvement
of global cognition and dual-task walking costs in 318 older
adults who had self-reported memory decline and a Clinical Dementia
Rating (CDR) global score of 0.5 or less at baseline. The primary
measurements used were changes in Montreal Cognitive Assessment
(MoCA) having a range of 0-30 and dual-task walking costs measuring
the difference between single and dual-task gait speed from the
baseline to 24 weeks, measured in percentages. Secondary outcomes
included Trail Making Test B, Digital Span Backwards, CDR-Sum of
Boxes (CDR-SB) and physical performance tests. Assessments were at
16, 24 and 48 weeks. Three hundred and four (304) of the 318 participants
completed the 24-week assessment. The cognitively enhanced
tai chi group outperformed the other two groups at the end of 24
weeks; the effects persisted at 48 weeks as well. The conclusion was
that the cognitively enhanced group’s therapy was superior to that of
the other two groups. The 24-week program consisted of practicing
tai chi two hours a week for the 24 weeks. The cognitively enhanced
group performed the normal tai chi moves, but also uttered words
and phrases while holding the various tai chi positions that were designed
to improve balance and flexibility.
The tai chi enhanced group experienced three times greater improvement
in cognitive skills compared to the stretching group. Li, et al. [105] provided cognitive training for mild cognitive impairment to two groups. One of the groups also received tai chi training. In the first
12 months, the tai chi group had additional positive effects. The tai chi
group received additional training after the first 12 months with the
result that cognitive impairment was further delayed. Liu, et al. [106]
assessed the effectiveness of tai chi improving cognitive, physical and
emotional function among persons with dementia by conducting a
systematic review of research on online databases. One group added
tai chi to their regular exercise routine while the control group merely
did exercise without the additional tai chi training. They found that
tai chi improved cognitive function with people who have dementia
(p = 0.007) but might not improve Timed Up and Go (TUG) and Geriatric
Depression Scale (GDS scores. Wang, et al. [107] searched various
databases and found 40 randomized control trials that concluded
that tai chi and qigong can improve cognitive function in patients
with neurological disorders. They concluded that tai chi and qigong
were effective in improving cognition in patients with Parkinson’s
disease, stroke, dementia, traumatic brain injury and mild cognitive
impairment. Yang, et al. [108] examined whether non-pharmaceutical
multi-component exercise training that combined tai chi with aerobics
and theraband therapy has a positive effect against age-related
neurocognitive and physical deterioration in elderly people who have
mild cognitive impairment (aMCI).
Evaluations were performed before and after 12-weeks intervention
and also after 24-week follow-up. The study found that the intervention
resulted in significant improvement in various neurocognitive
functions, especially in memory and frontal-related cognition, as
well as better performance on functional fitness, including cardiopulmonary
endurance, agility and muscle strength. The beneficial effects
remained after 24 weeks. The study concluded that such intervention
may protect against age-related neurocognitive and physical deficits
and could delay, or even reverse, the progression of MCI to dementia.
Yi, et al. [109] conducted a study whereby adults over 65 either
walked in an urban forest or did qigong exercises in the same forest.
Both groups participated in twelve two-hour sessions over a six-week
period. Neurological scores were computed for cognition, geriatric
depression and quality of life. Electroencephalography, bioimpedance
and heart rate variability were measured. Both groups were shown
to have had distinctive neuropsychological and electrophysiological
benefits as well as beneficial effects in terms of preventing dementia.
The qigong group showed alleviated depression and an increased bioimpedance
phase angel in the upper body. Xu, et al. [110] conducted
a randomized trial to assess the effect of tai chi combined with transcranial
direct current stimulation (tDCS) on the improvement of cognitive
function of patients having mild cognitive impairment (MCI).
The single-blind trial of 180 participants was conducted from April,
2018 to February, 2020.
Participants were divided into four groups – tai chi combined
with tDCS (TCT), tai chi combined with sham tDCS(TCS), walking
combined with tDCS(WAT) and walking combined with sham
tDCS(WAS). Assessment for global cognitive function, attention, executive
function and memory was done at baseline and after 12 weeks.
The TCT group showed significantly greater improvement in MOCA
scores, memory quotient scores and digit-symbol coding task reaction
time compared to the other three groups (p < 0.05). Hsu, et al.
[111] conducted a randomized controlled trial of 80 Taiwan patients
having mild to moderate cognitive impairment to determine whether
a three-month program using Chan-Chuang qigong would be effective
in improving muscle strength, muscle endurance, exercise capacity
and quality of life. The qigong group showed significant improvement
over the control group in muscle strength, muscle endurance and exercise
capacity after two and three months (p < 0.05). Physical quality
of life improvement was significant for the qigong group (p = 0.01)
but differences in mental quality of life between the two groups was
not significant (p = 0.83).
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ISSN: 2574 -1241
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