Chungnam National University, College of Nursing, Daejeon, 35015, Republic of Korea.
Indiana State University, Department of Psychology, Terre Haute, IN, 47802, USA.
BMC Geriatr. 2023 Jun 6;23(1):352. doi: 10.1186/s12877-023-04070-2.
Older adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways.
The objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach.
A systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software.
Our search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01, p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (β = 0.46, p = .011).
This meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function. PROSPERO REGISTRATION NUMBER: *PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358.
老年人由于衰老和慢性病的相互作用，身体和认知功能会出现与年龄相关的下降。太极拳和气功（TCQ）可能有益于改善这一人群的身体功能并延缓认知能力下降。为了确定 TCQ 通过直接或间接途径对认知功能的影响，探索了其潜在的作用机制。
本系统评价的目的是通过荟萃分析确定 TCQ 对老年人认知和身体功能的影响，并通过荟萃回归方法确定在控制身体功能的情况下 TCQ 对认知功能的影响。
系统检索了 13 个电子数据库（英文、韩语和中文），共确定了 2022 年 5 月之前发表的 10292 项潜在合格研究。使用 Cochrane 偏倚风险（版本 2.0）工具评估个体研究的偏倚。使用 95%预测区间评估研究的异质性，并使用 Comprehensive Meta-Analysis（版本 3）软件进行荟萃分析和荟萃回归。
我们的搜索共确定了 17 项随机研究（n=2365 人，平均年龄 70.3 岁）。使用随机效应模型的荟萃分析结果表明，TCQ 对认知（Hedges' g=0.29，95%置信区间 [CI] =0.17 至 0.42）和身体功能（Hedges' g=0.32，95%CI=0.19 至 0.44）均有显著影响。我们使用荟萃回归来探索 TCQ 与身体功能水平相关的效应大小。回归模型具有统计学意义（Q=25.01，p=0.070），身体功能作为调节变量解释了 55%的异质性。在控制身体功能的影响后，TCQ 对认知功能的影响仍然显著（β=0.46，p=0.011）。
这项对 17 项随机研究的荟萃回归强烈表明，TCQ 对老年人的身体和认知功能有有益的影响。在考虑身体功能作为调节变量的显著影响后，TCQ 对认知功能的影响仍然显著。这些发现意味着通过直接和间接增强身体功能来促进认知功能，TCQ 具有潜在的健康益处。PROSPERO 注册号：*PROSPERO 国际前瞻性系统评价注册中心，注册号 CRD42023394358。
