Abstract

BackgroundCognitive impairment places older adults at high risk of functional disability in their daily-life activities, and thus affecting their quality of life. This study aimed to examine the effects of Tai Chi on general cognitive functions and instrumental activities of daily living (IADL) in community-dwelling older people with mild cognitive impairment (MCI) in Hong Kong.MethodsThe study adopted a multi-site nonequivalent control-group pretest-posttest design. 160 community-dwelling older people, aged ≥60, with MCI, from four community elderly centers participated in the study. The intervention group (IG, n = 80) received training in the Yang-style simple form of Tai Chi, at a frequency of two lessons per week for 16 weeks. Each lesson lasted for one hour. The control group (CG, n = 80) had no treatment regime and joined different recreational activity groups in community centers as usual within the study period. Outcome measures included measures of global cognitive status and IADL. The Chinese version of the Mini-Mental State Examination (CMMSE) was used for global cognitive assessment. The Hong Kong Chinese version of Lawton’s Instrumental Activities of Daily Living (IADL-CV) was used to assess the participants’ IADL levels. General Estimating Equations (GEE) was used to examine each of the outcome variables for the two groups at the two study time points (the baseline and at the end of the study). Meanwhile, minimum detectable change (MDC) was calculated to estimate the magnitude of changes required to eradicate the possibility of measurement error of outcome measures.ResultsSeventy four participants in the IG and 71 participants in the CG completed the study. With adjustments for differences in age, education, marital status and living conditions, the findings revealed that the participants in the IG scored significantly better on the CMMSE test (P = 0.001), and the instrumental ADL questionnaire (P = 0.004). However, those scores changes did not exceed the limits of the respective MDCs in the study, the possibility of measurement variation due to error could not be excluded.ConclusionTai Chi may be an effective strategy to enhance cognitive health and maintain functional abilities in instrumental ADL in older people with MCI.Trial registrationNCT03404765 (Retrospectively registered January 19, 2018)

Highlights

  • Cognitive impairment places older adults at high risk of functional disability in their daily-life activities, and affecting their quality of life

  • In the Asia Pacific region, people diagnosed with dementia are expected to increase from 27 million in 2015 to 70 million by 2050 [2]

  • The study was conducted from December 2015 to September 2016

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Summary

Introduction

Cognitive impairment places older adults at high risk of functional disability in their daily-life activities, and affecting their quality of life. This study aimed to examine the effects of Tai Chi on general cognitive functions and instrumental activities of daily living (IADL) in community-dwelling older people with mild cognitive impairment (MCI) in Hong Kong. As ageing population is rising all over the world, agerelated cognitive decline has been highlighted as a public health concern worldwide. 47.5 million people worldwide live with dementia, and there are 7.7 million new cases every year. These figures are projected double every twenty years, reaching 75.6 million in 2030 and 135.5 million in 2050 [1]. The aging population in Hong Kong is largely a consequence of a longer life expectancy and lowering fertility rate. The prevalence rate of dementia is projected to increase by 222% from 2009 to 2039 [5]

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