Tai chi is linked to global cognitive function with more improvements than those gained with conventional exercise.
In a recent study, Parco Siu, BSc, MPhil, PhD, FRSB, FACSM, FECSS, FHKASMSS, Associate Professor and Division Head of the Department of Kinesiology at the University of Hong Kong, and colleagues found clinically significant global cognitive improvements in study participants who engaged in 24 weeks of tai chi compared to participants who engaged in conventional exercise.
While both groups who engaged in physical activity achieved significantly higher results in cognitive tests measuring short term memory, executive function, attention, concentration and working memory, the tai chi group tended to show greater improvements.
“The participants who received tai chi training reached a clinical relevance improvement in global cognitive function ahead of those who received conventional exercise training,” says Siu. “In the cognitive domains that both exercises improved, tai chi led to a more robust improvement in cognitive flexibility compared with conventional exercise, indicated by a larger decrease in the part B/A ratio score of the Trail Making Test.”
The Trail Making Test measures visual attention and task switching via two parts, scored by the length of time it takes for participants to complete each section.
How Tai Chi Improves Cognitive Function
According to Siu, tai chi, as a mind-body exercise, may improve cognitive function in multiple ways.
First, tai chi is an exercise modality with light-to-moderate intensity, and adequate moderate-intensity physical activities have been shown to benefit cognitive health.
“Individuals can obtain benefits in cognitive function by achieving the recommended amount of physical activity through performing tai chi,” Siu says. “Moreover, tai chi movements require specific skills. The specific requirements of body movement in tai chi can be regarded as a kind of motor training.”
Second, preliminary evidence shows that meditation has favorable effects on cognitive function in older adults with mild cognitive impairment. The meditation element of tai chi may also contribute to the improvement in cognitive function; however, the effects of meditation in tai chi on improving cognitive health are unknown and require further investigation.
Third, unlike most conventional exercises comprised of simple repetitive movements, such as walking or swimming, tai chi consists of a series of forms — specific positions of the body.
“While practicing tai chi, the individuals need to transition from form to form smoothly,” Siu says. “Notably, each form has specific requirements in meditation, posture and movements. The individual needs to adopt a new set of requirements while transitioning from one form to another, and therefore may train up the capability of selectively switching between mental processes to achieve appropriate behavioral responses, and efficient adaptation to the change in requirements or demands (i.e. cognitive flexibility).”
Lastly, tai chi is thought to create beneficial changes in the brain, which other studies seem to confirm. Specifically, a 2018 study by Angus P. Yu et al reports a brain adaption from tai chi in regions of the brain responsible for gait, balance, mood and cognitive function. Additionally, a 2021 pilot study led by Lei Cui indicates functional changes in the brain that associate tai chi with improvement in cognitive flexibility.
However, further research is needed to fully understand how tai chi improves global cognitive function and creates beneficial changes in the brain.
In Clinical Practice
Since there is no current cure for dementia, healthcare providers often recommend strategies that may prevent or delay cognitive decline. Regular exercise is one of those strategies.
However, for older adults, fear of injury or concern about starting an exercise program that is perceived as too difficult may be a hindrance in getting enough regular physical activity. Tai chi could provide a safe alternative for older patients who need activity recommendations.
“It is noteworthy that the slow and low-impact movements of tai chi make it a safe exercise for older adults who are physically unfit or with chronic conditions,” Siu says. “Tai chi can be a good option for older adults to engage in regular exercise for preventing cognitive decline. Primary care providers may consider recommending tai chi to patients as one of the approaches to prevent cognitive decline.”
However, Siu emphasizes that providers should recommend numerous approaches to cognitive health — not one exercise modality alone.
According to Siu, the frequency and duration of physical activity sufficient to prevent cognitive decline — whether tai chi or other conventional exercise — remains unclear. Further research is required to determine an effective exercise recommendation to protect patients against cognitive impairment.