A Mobile Tai Chi Platform for Fall Prevention in Older Adults

Project Summary Exercise-based interventions have been recently shown to have great potential for preserving and restoring cognitive function in older adults. In this context, Tai Chi has gained the interest of researchers and clinicians because it incorporates physical, cognitive, social, and meditative components within the same activity. Such multimodal exercise modality is expected to have a positive effect on older adults’ executive and global cognitive function, including attentional control, planning, response to inhibition, and working memory. Hence, Tai Chi- based interventions could help researchers and clinicians to address cognitive decline and dementia in older adults. In the proposed study, we will recruit a small cohort of older adults, 65-85 years of age, with mild cognitive impairments, and ask them to participate in a 12-week home-based Tai Chi program. The study will rely on a tele-health system that our team recently developed as part of the parent award (#R42AG059491). Subjects will be evaluated pre- and post-intervention using a battery of tests chosen to assess the impact of the intervention on executive and global cognitive function, physical function, and quality of life. This battery of tests will include, as primary outcome measures, the Trail Making Test (to assess the impact of the tele-Tai Chi intervention on cognitive function) and the Dual task Stride Time Variability (DSTV) test (to assess the impact of the tele-Tai Chi intervention on combined physical and cognitive function). In addition, this battery of tests will include, as secondary outcome measures, standard assessments of physical function such as the Timed Up-and-Go test, handgrip strength, the Physical Activity Scale for the Elderly, and the Activities Specific Balance Confidence (ABC) questionnaire. Health-related quality-of-life will be assessed using the SF-12. Depressive symptoms will be assessed with the Center of Epidemiology Studies-Depression Scale Revised. Self-reported functional capacity will be assessed with the Instrumental Activities of Daily Living. These data will be compared pre- vs. post-intervention to derive effect size estimates and power a future, larger scale study.Project Narrative There is a growing interest for the development and assessment of exercise-based interventions to slow the progression of age-related cognitive decline and dementia. Recent literature suggests that Tai Chi provides an exercise modality that is particularly suitable to preserve and restore executive function, including important cognitive skills such as attentional control, planning, response to inhibition, and working memory. The proposed pilot study is meant to provide a preliminary assessment of the effects on older adults with mild cognitive impairments of a Tai Chi-based exercise program delivered in the home setting using a tele-health system.