Tai chi or health education for older adults with hypertension: effects on mental health and psychological resilience to COVID-19

Effects of Tai Chi and Qigong intervention on anxiety and stress in diabetic and hypertensive Brazilian patients: a randomized controlled trial

OBJECTIVE

This study investigated the effects of Tai Chi/Qigong practice over 13 weeks on anxiety and perceived stress levels in middle-aged or older Brazilian hypertensive and diabetic individuals assisted in a primary healthcare setting.

METHODS

Ninety-one patients with diabetes mellitus and/or hypertension diagnosed and followed up at a primary care center were randomized to the Tai Chi/Qigong intervention (n = 45) or waitlist (n = 46) group for 13 weeks. Outcome measures were collected at baseline and at 6 and 13 weeks for anxiety (State-Trait Anxiety Inventory [STAI]) and stress (Perceived Stress Scale - PSS14). The primary endpoint of the study was 13 weeks. We used a linear mixed-effects model to analyze the primary and secondary outcomes, considering the treatment group and time as covariates and treating the subject as a random effect.

RESULTS

Of the included 91 participants, 53 completed the 6-week assessment, and 42 completed the 13-week assessment. After 13 weeks, the Tai Chi/Qigong Group had lower scores for anxiety (STAI Estimate = -6.421; SD = 2.679; 95% confidence interval (95%CI) = [-11.615,-1.224]; p = 0.018) and stress (PSS14 Estimate = -9.290; SD= 2.262; 95%CI= [-13.678,-4.906]; p<0.001).

CONCLUSION

A 13-week Tai Chi/Qigong intervention was efficacious in lowering anxiety and perceived stress scores in middle-aged and older patients with diabetes mellitus and hypertension and can potentially be used in primary care centers as an adjunct therapy.Trial registration: Brazilian Registry of Clinical Trials (ReBEC), Identifier: U1111-1276-1787.

Psychosocial and mental health status among older adults in China during the COVID-19 pandemic: A cross-sectional study

BACKGROUND

On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. During the virus's spread and subsequent lockdowns, older adults faced heightened risks and significant mental health challenges.

METHODS

A cross-sectional study was conducted in Shandong Province, China, using a custom-designed demographic questionnaire, a COVID-19-related survey, and the Symptom Checklist-90 Revised (SCL-90-R). Correspondence analysis and multiple linear regression models were employed to examine factors influencing the mental health of older adults.

RESULTS

Among 3363 older adults, the total SCL-90-R score was 153.11 ± 36.98, with an average score of 1.70 ± 0.41. Both scores were lower than the Chinese norm and pre-pandemic levels. Factors significantly affecting older adults' mental health included place of residence, age, educational attainment, marital status, fear of COVID-19, understanding of COVID-19 transmission routes, and awareness of preventive measures.

CONCLUSIONS

Greater attention is needed to address the mental health of older adult males, individuals of advanced age, employed individuals, those with lower educational backgrounds, and those without a spouse. Policymakers should implement targeted policies and interventions to enhance mental health support for older adults.

The impact of mind-body exercise on the quality of life in older adults: the chain mediation effect of perceived social support and psychological resilience

Background

With the intensification of the global aging trend, there is a contradiction between the extended lifespan and the decline of physiological functions among the older adult. It has become a global consensus to focus on and improve the quality of life for the older adult. Mind-body exercises (Tai Chi, Ba Duan Jin, Yi Jin Jing) play a crucial role in promoting the quality of life for older adults, but the mechanisms and mediating effects are not yet clear.

Objective

This study examines the impact of mind-body exercises (Tai Chi, Ba Duan Jin, Yi Jin Jing) on the quality of life in older adults, with a particular focus on exploring the chain mediating effects of perceived social support and psychological resilience.

Methods

This study is a cross-sectional study that surveyed 1,087 older adults participating in mind-body exercises (Tai Chi, Ba Duan Jin, Yi Jin Jing) in 13 districts of Beijing, China, from March 25 to May 3, 2024. The Physical Activity Rating Scale (PARS-3), the World Health Organization Quality of Life Scale (WHOQOL-BREF), the Perceived Social Support Scale (PSSS), and the Connor-Davidson Resilience Scale (CD-RISC) were used to measure mind-body exercise, perceived social support, psychological resilience, and quality of life, respectively. Data were statistically analyzed using SPSS 26.0, and mediation effects were tested and effect analysis was conducted through structural equation modeling (AMOS) and the Bootstrap method.

Results

The study results show that mind-body exercises (Tai Chi, Ba Duan Jin, Yi Jin Jing) are significantly and positively correlated with the quality of life in older adults (r = 0.549, p < 0.01). The path coefficients for the relationships mind-body exercise → perceived social support (β = 0.46, p < 0.001) → psychological resilience (β = 0.20, p < 0.001) → quality of life in older adults (β = 0.39, p < 0.001) are significant, indicating that perceived social support and psychological resilience have a chain mediating effect between mind-body exercise and the quality of life in older adults.

Conclusion

Mind-body exercises not only improve the quality of life for older adults but also indirectly enhance it by strengthening perceived social support and psychological resilience. This study provides significant reference for developing health intervention strategies targeted at older adults, suggesting that promoting mind-body exercises can improve their sense of perceived social support and psychological resilience, thereby increasing their quality of life.

Post-traumatic stress in older, community-dwelling adults with hypertension during the COVID-19 pandemic: An investigation of pre-pandemic sociodemographic, health, and vascular and inflammatory biomarker predictors

COVID-19 pandemic-related traumatic stress (PRTS) symptoms are reported in various populations, but risk factors in older adults with chronic medical conditions, remain understudied. We therefore examined correlates and pre-pandemic predictors of PRTS in older adults with hypertension during COVID-19. Participants in California, aged 61-92 years (n = 95), participated in a pre-pandemic healthy aging trial and later completed a COVID-19 assessment (May to September 2020). Those experiencing ⩾1 PRTS symptom (n = 40), and those without PRTS symptoms (n = 55), were compared. The PRTS+ group had poorer mental and general health and greater impairment in instrumental activities of daily living. Pre-pandemic biomarkers of vascular inflammation did not predict increased odds of PRTS; however, greater pre-pandemic anxiety and female gender did predict PRTS during COVID-19. Our findings highlight PRTS as a threat to healthy aging in older adults with hypertension; targeted approaches are needed to mitigate this burden, particularly for females and those with pre-existing anxiety.