Tai Chi

Study Finds Enhanced Tai Ji Quan Practice Improved Memory and Walking in Older Adults

MedicalResearch.com Interview with:

Peter A. Harmer, PhD, MPH, AT-Ret, FACSMSenior Associate Research Scientist Oregon Research Institute

Dr. Harmer

Peter A. Harmer, PhD, MPH, AT-Ret, FACSM

Senior Associate Research Scientist
Oregon Research Institute

MedicalResearch.com: What is the background for this study?

Response: Decline in various aspects of cognitive function, such as memory, executive function, and multitasking ability is common as we age. The rate and extent of decline varies among older adults but approximately 20% of those aged 65+ will experience clinically relevant mild cognitive impairment, which places them at increased risk of progressing to Alzheimer’s disease or related dementias. It is also associated with decreased mobility, increased risk of falls and impaired capacity for complex activities of daily living.

Research has shown that physical and mental activity may attenuate the decline and that combined physical/mental challenges may be more effective than either alone but up to this point there has been little quality clinical evidence. Building on previous successful studies with our established tai ji quan therapy, we developed a cognitively-enhanced training tai ji quan protocol to determine its effectiveness in enhancing global cognition and dual-task walking compared to our standard tai ji quan program and a stretching program in adults 65+ with mild cognitive impairment or self-reported memory concerns.

Tai ChiMedicalResearch.com: What are the main findings?

Response:  After 24 weeks, participants in the enhanced tai ji quan group had greater improvements in global cognition (as measured by Montreal Cognitive Assessment (MoCA)) scores and dual-task walking than either of the other two exercise groups. With no active intervention after 24 weeks the training induced benefits persisted at 48-week follow-up.

MedicalResearch.com: What should readers take away from your report?

Response: Findings from this study suggest that augmented tai ji quan practice that incorporates a mix of interactive, cognitively stimulating, dual-tasking exercises may be more advantageous than conventional practice approaches in achieving greater cognitive benefits for older adults who have trouble with their memory and experience difficulty in performing dual-task daily activities. These benefits may translate into helping older adults attenuate progression of cognitive decline and mitigate their risk of falling, as well as increase their walking speed and improve their postural control.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Future research goals include incorporating participants with more severe cognitive impairment and developing models to examine the specific neural mechanism(s) that may be responsible for the improvements associated with our new cognitively enhanced protocol.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response: In addition to the specific outcomes examined in this study, the tai ji quan protocol has several inherent advantages as a modality for improving health-related quality of life in older adults, including being low impact, self-paced, readily modifiable to account for physical limitations, and self-contained (i.e., no equipment; small footprint).

Finally, it should be noted that this study was one of the first large-scale exercise clinical trials to be conducted virtually (recruitment, interventions and assessments). This successful application of an eHealth approach provides a promising model for expanding the reach of research studies and accessibility to effective interventions for underserved populations.


Fuzhong Li, Peter Harmer, Elizabeth Eckstrom, et al. Clinical Effectiveness of Cognitively Enhanced Tai Ji Quan Training on Global Cognition and Dual-Task Performance During Walking in Older Adults With Mild Cognitive Impairment or Self-Reported Memory Concerns: A Randomized Controlled TrialAnn Intern Med. [Epub 31 October 2023]. doi:10.7326/M23-1603

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Last Updated on November 1, 2023 by Marie Benz