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

Author: Jordan N Kohn1,2, Judith D Lobo1, Emily A Troyer1, Kathleen L Wilson3, Gavrila Ang1, Amanda L Walker3, Christopher Pruitt3, Meredith A Pung3, Laura S Redwine4,5, Suzi Hong1,3
Affiliation: <sup>1</sup> Department of Psychiatry, University of California San Diego, La Jolla, CA, USA. <sup>2</sup> Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA. <sup>3</sup> Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA. <sup>4</sup> College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA. <sup>5</sup> Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA.
Conference/Journal: Aging Ment Health
Date published: 2022 Mar 21
Other: Special Notes: doi: 10.1080/13607863.2022.2053836. , Word Count: 253


Objective:
To compare the effectiveness of 12 weeks of community-based, in-person, group Tai Chi (TC) and Health Education (HAP-E) in improving health and wellbeing in older adults with hypertension and in promoting psychological resilience during COVID-19.

Methods:
A 12-week randomized controlled trial (RCT) in San Diego County, USA. Self-reported depressive symptoms, anxiety, sleep disturbances, gratitude, resilience, mental and physical health were assessed in-person pre- and post-intervention, and by long-term follow-up surveys during COVID-19. Linear mixed-effects models were used to assess study arm differences over time and logistic regression to identify predictors of positive intervention response.

Results:
Of 182 randomized participants (72.6 ± 7.9 yrs; 72% female), 131 completed the intervention. Modest improvements in health and wellbeing occurred post-intervention in both arms (Cohen's d: TC = 0.38, 95% CI: 0.25-0.51; HAP-E = 0.24, 0.11-0.37), though positive intervention responses were more than twice as likely in TC (OR = 2.29, 1.07-4.57). Younger age, higher anxiety, and poorer mental health at baseline predicted greater odds of response. Small declines in health and wellbeing were reported at the first COVID-19 follow-up, with smaller declines in the TC arm (Cohen's d: TC = -0.15, -0.31-0.00; HAP-E = -0.34, -0.49 to -0.19). Health and wellbeing stabilized at the second COVID-19 follow-up. Most participants (>70%) reported that the interventions benefitted their health and wellbeing during COVID-19.

Conclusion:
TC and HAP-E improved health and wellbeing, though TC conferred greater odds of an improved mental health response. Declines in health and wellbeing were observed at pandemic follow-up, with smaller declines in the TC arm, suggesting increased resilience.

Keywords: COVID-19; Tai Chi; hypertension; psychological well-being; resilience.

PMID: 35311437 DOI: 10.1080/13607863.2022.2053836