Correlation Between Cognition and Balance Among Middle-Aged and Older Adults Observed Through a Tai Chi Intervention Program

Effect of combined physical-cognitive training on the functional and cognitive capacity of older people with mild cognitive impairment: a randomized controlled trial

BACKGROUND

The increase in population aging highlights the growing prevalence of mild cognitive impairment, prompting the adoption of interventions that combine physical exercise and cognitive training to improve health and cognitive performance in older adults. The aim of this study was to analyze the efficacy of a combined program on physical and cognitive health in older people with cognitive impairment.

METHODS

A 12-week randomized controlled clinical trial involving 95 participants (aged 72.12 ± 4.25 years), 47 individuals participated in a control group (CG) that only underwent cognitive stimulation, while 48 individuals were in an experimental group (EG) that participated in a combined program. Balance was measured using the Tinetti scale, upper body strength was assessed with the arm curl test, lower body strength was evaluated with the 30-s chair stand test, flexibility was tested using the back scratch test and chair sit-and-reach test, physical function was measured with the Timed Up and Go test, cognitive function was assessed using the Mini Mental State Examination, cognitive impairment was evaluated with the Montreal Cognitive Assessment, verbal fluency was tested with the Isaac test, and executive functions were assessed using the Trail Making Test.

RESULTS

The results of the study show significant improvements in both physical and cognitive aspects, such as balance, gait, upper and lower body strength, flexibility, physical function, cognitive function, cognitive impairment, verbal fluency, and executive functions in the group that carried out the intervention compared to the control group.

CONCLUSION

A combined program for older individuals with mild cognitive impairment leads to enhancements in physical and cognitive health. These improvements underscore the importance of integrating physical exercise with cognitive training as an effective strategy for enhancing overall health and quality of life in older adults.

TRIAL REGISTRATION

NCT05503641.

The relationship between postural control and cognitive functioning following Zumba dancing in middle-aged women: A randomized clinical trial

This study aimed to investigate the effect of 12-week Zumba dancing on postural control and cognitive parameters and the correlations between these parameters in middle-aged women. Thirty-eight women, aged between 50 and 60 years, were randomly allocated to a Zumba group (ZG) or control group. Postural control and cognitive functions [working memory (WM) and reaction time (RT)] were assessed before and after 12 weeks of a Zumba dancing program using a stabilometric force platform, Corsi Block-Tapping Task and Simple RT tests, respectively. The results indicate that ZG showed significantly (p<.01) better balance performances when standing on a stable surface in both visual conditions [firm surface with eyes opened (EO) (20,9%) and eyes closed (EC) (12.3%)]. However, when standing on an unstable surface in both visual conditions (foam surface with EO/EC), the ZG showed no significant improvement in postural control. It seems that the benefits of Zumba on postural control depend on the sensory condition. Besides, 12-week Zumba dancing was not sufficient to significantly enhance cognitive performances (RT/WM) performances. These cognitive performances were related to postural control in challenging conditions and can be considered an effective tool for monitoring postural performances following an intervention program. Clinicians should, therefore, focus on interventions that boost cognitive functions in middle-aged women to achieve optimal postural control, mainly in challenging conditions, in order to prevent the risk and fear of falls as well as the incidence of falling.

Effects of Bafa Wubu and He-Style Tai Chi exercise training on physical fitness of overweight male university students: A randomized controlled trial

This study aimed to compare the effects of 12-week Bafa Wubu Tai Chi (BW-TC) and traditional He-style Tai Chi (TH-TC) exercise training on physical fitness parameters in overweight university students and to compare the differences in their effects. A total of 81 overweight male university students were randomly assigned to the BW-TC group (N = 27), the TH-TC group (N = 27), and the control group (CG, N = 27). Upper limb grip strength, wall squat, sitting and reaching, 6-minute walk, single-leg stance, and Y-balance were measured at baseline and after 12 weeks of Tai Chi training. There were no significant differences in demographic characteristics and assessment parameters among the groups at baseline (p>0.05). Both BW-TC and TH-TC performed Tai Chi exercise program training lasting 12 weeks, with three sessions per week, each lasting 60 minutes intervention. The changes in mean scores for the sit-and-reach test were 3.11 cm and 4.52 cm, for the wall squat test were 27.56 s and 36.85 s, and for the 6-minute walk test were 22.93 m and 63.22 m, and Y-balance (p<0.05) significantly increased in both BW-TC and TH-TC groups, while the mean score of single-leg stance significantly decreased (p<0.05). Additionally, compared to the BW-TC group, the TH-TC group showed a significant increase in lower limb strength (13.89 s, p = 0.048) and the distance of the Y-balance test in the left posterior medial direction (4.04 cm, p = 0.031). BW-TC and TH-TC interventions effectively improved physical fitness in overweight university students. However, TH-TC showed superior results in lower limb strength improvement. Trial registration number: ChiCTR2200059427 (https://www.chictr.org.cn).

Higher Dynamic Balance Performance Was Associated With Cognitive Function Among U.S. Community-Dwelling Low-Income Older Adults

Introduction

Multiple studies have reported the association between balance performance and cognitive function among older adults. However, few studies have been conducted in low-income settings.

Objectives

This cross-sectional study examined the relationships of dynamic and static balance with cognitive function in community-dwelling low-income older adults in Orlando, Florida.

Methods

Dynamic balance was assessed with a Short Physical Performance Battery (SPPB) and static balance with BTracks Balance System. Rowland Universal Dementia Assessment Scale (RUDAS) assessed cognition and Patient Health Questionnaire-9 assessed depressive symptoms.

Results

Multiple regression analysis showed dynamic balance was significantly associated with cognition, but static balance was not, controlling for depressive symptoms (N = 89, M age  = 72.70, SD ± 6.95; females = 79). Specifically, higher dynamic balance was associated with better cognitive function. Cognitively healthy participants (RUDAS scores ≥23) scored 2.526 points higher in SPPB than those with possible cognitive impairment (RUDAS scores <23).

Conclusions

Findings provide the evidence to suggest dynamic balance and cognitive function health disparities affecting older adults from low-income community. By implication, dynamic balance and cognitive function should be part of routine screening with older adults living in low-income communities.

Capturing key function-focused care problems, nursing diagnoses, and interventions for nursing home patients using a web-based case management system

PURPOSE

The aim of this study is to identify the key functional care problems, NANDA-I nursing diagnoses, and intervention plans related to function-focused care (FFC) using a web-based case management system for patients who present different cognitive status.

METHODS

This study employed a retrospective descriptive research design. Data were obtained from system records on patients after the research team trained the case management system at a nursing home in Dangjin in South Chungcheong Province, South Korea. A total of 119 inpatient records were analyzed.

RESULTS

The key physical, cognitive, and social functional problems, nursing diagnoses in six domains (health promotion, elimination and exchange, activity/rest, perception/cognition, coping/stress tolerance, and safety/protection), and intervention plans were identified.

CONCLUSION

The identified FFC case management information of interdisciplinary caregivers will provide evidence for the implementation of effective interventions according to a patient's functional status. Additional studies related to the establishment of a large clinical database of advanced case management systems focusing on interdisciplinary caregivers' functional management are needed to support the prioritization of functional care.

Does enhanced cognitive performance reduce fracture risk? a Mendelian randomization study

OBJECTIVE

While observational studies have suggested a link between cognitive performance and fracture risk, the causality and site-specific nature are unclear. We applied Mendelian randomization (MR) to elucidate these associations.

METHODS

147 single-nucleotide polymorphisms (SNPs) tied strongly to cognitive performance (p< 5e-8) were selected. We performed MR analysis to investigate the causal relationship between cognitive performance and fractures at specific sites, including the wrist, upper arm, shoulder, ribs, sternum, thoracic spine, lumbar spine, pelvis, femur, leg, and ankle. The primary estimate was determined using the inverse variance-weighted method. Additionally, we examined heterogeneity using the MR Pleiotropy RESidual Sum Outlier test and Cochran Q, and employed MR-Egger regression to identify horizontal pleiotropy.

RESULTS

MR analysis identified a causal association between cognitive performance and fractures at the lumbar-spine-pelvis (odds ratio [OR] = 0.727, 95% CI = 0.552-0.956, p = 0.023), and ribs-sternum-thoracic spine sites (OR = 0.774, 95% CI = 0.615-0.974, p = 0.029). However, no causal association was found for fractures at other sites.

CONCLUSIONS

This study provided evidence of a causal connection between cognitive performance and fracture risk at certain locations. These findings underline the potential of cognitive enhancement strategies as innovative and effective methods for fracture prevention.

Does tandem balance test predict cognitive impairment among older adults? Findings from Longitudinal Ageing Study in India, 2017-18

BACKGROUND

Ageing entails a decline in physical and functional abilities including a reduced body balance due to complex integration and coordination of sensory acuity, motor control, neural and cognitive functions. This study aimed to examine the association between tandem balance test and cognitive impairment among older Indian adults. The study also examined the gender differentials in the associations with an interaction analysis.

METHODS

Data for this study were drawn from the recent release of the Longitudinal Ageing Study in India (2017-18). The total sample size for the present study included 26,539 older adults age 60 years and above. Descriptive statistics and bivariate analysis were used to present the preliminary results. Two sample proportion test was used to evaluate the significance for gender differences. Further, multivariable binary logistic regression analysis was used to evaluate the independent association of balance test performance and cognitive impairment among older adults.

RESULTS

Nearly 16% of male and 26% of female older adults could not finish full tandem test in this study. There were significant gender differences in cognitive impairment among older adults (male-6.5% and female-18.9%). The likelihood of cognitive impairment was significantly higher among older adults who could not finish the full tandem test compared to those who finished the tandem test [AOR: 1.22; CI: 1.09-1.36]. The interaction model revealed that older females who could not finish the full tandem test were 2.11 times significantly more likely to be cognitively impaired in reference to older males who finished the full tandem test [AOR: 2.11; CI: 1.81,2.45]. Similarly, older females who finished the full tandem test were 2.42 times significantly more likely to be cognitively impaired in reference to older males who finished the full tandem test [AOR: 2.42; CI: 2.02,2.88].

CONCLUSION

The findings of the study suggest that healthcare professionals working with older adults should consider the results of a balance test to screen for their risk of cognitive impairment. Results from the relationship between failing to finish the tandem test and cognitive impairment may be helpful for identifying older men and women who are at higher risk of experiencing mobility decline and their progression to dementia.

Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis

Knee Osteoarthritis (KOA) is the most common type of knee joint injury and also a risk factor for multiple health consequences and is prevalent among older women. The updated clinical guidelines for KOA treatment by the American Rheumatism Association recommend Tai Chi exercise. However, a literature review outlined limitations in Tai Chi intervention implementations. This study aimed to address some of the gaps. This study selected thirty female patients to participate in Tai Chi exercises and undergo relevant tests. The subjects were randomly assigned to Tai Chi or education groups. Independent sample t-tests were conducted to compare the difference in health indicators between the two groups after the intervention. The difference-in-differences (DID) regression was performed to assess the difference in the health outcomes between the two groups at baseline and follow-up and the difference in the differences. After the completion of the intervention, the Tai Chi group reported significantly improved KOA symptoms, physical fitness, and health status indicators than the control group. Specifically, the group differences were significantly larger at the baseline than at the follow-up. Our findings provide compelling evidence of the effects of the innovative Tai Chi exercise prescription specifically designed for KOA patients. The empirical evidence on its effectiveness in alleviating KOA symptoms and improving the overall health of middle-aged and elderly women with KOA suggested that Tai Chi intervention exercise has huge prospects for integration in KOA rehabilitation therapy.

Grip Strength Trajectories and Cognition in English and Chilean Older Adults: A Cross-Cohort Study

Growing evidence about the link between cognitive and physical decline suggests the early changes in physical functioning as a potential biomarker for cognitive impairment. Thus, we compared grip-strength trajectories over 12-16 years in three groups classified according to their cognitive status (two stable patterns, normal and impaired cognitive performance, and a declining pattern) in two representative UK and Chilean older adult samples. The samples consisted of 7069 UK (ELSA) and 1363 Chilean participants (ALEXANDROS). Linear Mixed models were performed. Adjustments included socio-demographics and health variables. The Declined and Impaired group had significantly lower grip-strength at baseline when compared to the Non-Impaired. In ELSA, the Declined and Impaired showed a faster decline in their grip strength compared to the Non-Impaired group but differences disappeared in the fully adjusted models. In ALEXANDROS, the differences were only found between the Declined and Non-Impaired and they were partially attenuated by covariates. Our study provides robust evidence of the association between grip strength and cognitive performance and how socio-economic factors might be key to understanding this association and their variability across countries. This has implications for future epidemiological research, as hand-grip strength measurements have the potential to be used as an indicator of cognitive performance.

The Effects of High-Intensity Functional Training on Cognition in Older Adults with Cognitive Impairment: A Systematic Review

(1) Background: High-Intensity Functional Training (HIFT) is a new exercise modality that emphasizes multi-joint functional movements adaptable to any fitness level and promotes greater muscle recruitment. Previous studies have evaluated the positive effects of HIFT on mental and cognitive health but have not evaluated it in older people. This study aims to conduct a systematic review of randomized controlled trials assessing the effects of HIFT on general cognition in older adults with cognitive impairment. (2) Methods: Following the PRISMA 2020 guideline, articles that did a high-intensity functional physical exercise intervention on cognitive performance in older adults with mild to moderate cognitive impairment (MMSE > 10) or dementia, aged 55 years or older, published between 2011 and 2021 in five different electronic databases: PubMed, Web of Science, Scopus, CINAHL, and Cochrane plus were included. (3) Results: 7 articles were included, all having general cognition as their primary outcome. All assessed general cognition using the Mini-Mental State Examination, the ADAS-Cog, or both. All studies had at least one HIFT experimental group with a frequency of 2 sessions per week and a variable duration between protocols of 12, 13, 16, and 26 weeks. Two articles showed that a progressive HIFT program improves general cognition, four articles showed no significant changes within or between groups and one article concluded that a HIFT intervention does not slow cognitive decline. (4) Conclusions: Evidence exists of the benefits of HIFT on general cognition in older adults with cognitive impairment, assessed using the MMSE, the ADAS-cog, or both. Two articles that showed improvement in cognitive function used progressive HIFT with 80% RM at 6, 12, and 1 weeks; however, in the other articles, due to the heterogeneity of intervention protocols, measurement time points, and control group activities, mixed results were evidenced

Best-Compromise Control Strategy Between Mechanical Energy Expenditure and Foot Clearance for Obstacle-Crossing in Older Adults: Effects of Tai-Chi Chuan Practice

Background: Obstacle-crossing increases the risk of falls in older people. This study aimed to identify the effects of long-term Tai-Chi Chuan (TCC) practice on the control strategies for obstacle-crossing in older people.

Methods: A multi-objective optimal control technique with measured gait data was used to identify the control strategies adopted by 15 long-term TCC practitioners and 15 healthy controls when crossing obstacles of different heights, in terms of the best-compromise weighting sets for the conflicting objectives of minimizing energy expenditure and maximizing the toe-obstacle and heel-obstacle clearances.

Results and Conclusions: The long-term TCC older practitioners adopted a best-compromise control strategy similar to those adopted by young adults, with greater weightings on the minimization of the mechanical energy expenditure and smaller weightings on foot-clearance as compared to non-TCC controls (TCC: 0.72, 0.14, 0.14; Control: 0.55, 0.225, 0.225). This strategy enabled the long-term TCC older practitioners to cross obstacles with significantly greater leading-toe clearances but with relatively less mechanical energy expenditure. With the current approach, further simulations of obstacle-crossing mechanics with a given weighting set will be useful for answering clinically relevant what-if questions, such as what abilities would be needed if the non-TCC older people were to cross obstacles using the crossing strategy of the TCC people.

Effects of Tai Chi Softball Exercises on Physical Fitness Level and Cardiovascular Health-Related Factors among Older Females

Tai Chi softball was voted as one of the most popular health-promoting exercises and can also develop manipulative skill and hand-eye coordination. The purpose of this study was to explore changes in the physical fitness level and cardiovascular health-related factors after the 16-week Tai Chi softball (TCSB) training program among older females. One hundred healthy older females were assessed at the baseline before TCSB training, and then, they conducted intervention experiments. Through the 16-week TCSB intervention training, a control group and a physical exercise group showed significant differences. The physical exercise group significantly reduced body mass index, systolic blood pressure, and diastolic blood pressure from all the results studied. It also reduces total cholesterol, triglycerides, low-density lipoprotein cholesterol ( ∗ p < 0.05), and waist-to-hip ratio ( ∗∗ p < 0.01), whereas handgrip, sit and reach, single leg stance, vital capacity ( ∗ p < 0.05), and high-density lipoprotein cholesterol ( ∗∗ p < 0.01) were significantly increased. TCSB training may improve physical fitness ability and decrease the risk of cardiovascular disease among older females.

Dual-Task Training Affect Cognitive and Physical Performances and Brain Oscillation Ratio of Patients With Alzheimer's Disease: A Randomized Controlled Trial

This study aimed to investigate the effect of 12 weeks of dual-task training on cognitive status, physical performance, and brain oscillation of patients with Alzheimer's disease (AD). Twenty-six AD patients were randomly assigned to two groups, the training group (TG) and control group (CG). TG executed progressive combined exercises with visual stimulation twice a week for 12 weeks. Training included muscle endurance, balance, flexibility, and aerobic exercises with eyes closed and opened. Brain oscillation on electroencephalography (EEG) and a series of physical, cognitive, and mental tests were taken before and post-intervention. There was a significant improvement after training protocol in cognitive function, particularly in short-term and working memory, attention, and executive function (p < 0.01). Besides, there were substantial improvements in depression status (GDS scale), aerobic fitness (6 min walking), flexibility (chair sit and reach) functional ability (chair stand, timed up and go test), strength (knee extensions, preacher biceps curl, handgrip) in TG compared to CG. These signs of progress were associated with a significant increase (p < 0.05) in the frequency of brain oscillation and a decrease in the theta/alpha ratio. In addition to physical performance, the regular combined training with visual stimulation improves brain health as indicated by improving cognitive function and reducing the theta/alpha ratio. Clinical Trial Registration: Iranian Registry of Clinical Trials (IRCT) https://www.irct.ir/, identifier IRCT20190504043468N1-August 5, 2020.