Health benefits of traditional Chinese sports and physical activity for older adults: A systematic review of evidence

Feasibility and Acceptability of Qigong Exercise in Community-Dwelling Older Adults in the United States

OBJECTIVES

Qigong exercise has been shown to improve physical and psychological well-being in adults with chronic conditions, but little is known about the feasibility and acceptability of engaging in a qigong exercise program in community-dwelling older adults in the United States. The purpose of this study was to explore the feasibility, acceptance, and adherence to an 8-week qigong exercise intervention in community-dwelling American older adults.

DESIGN

An exploratory study design.

SETTING

Two senior centers in southern Connecticut.

SUBJECTS

Forty-five community-dwelling older adults aged 65 to 85 years enrolled.

INTERVENTION

A supervised 1-h health qigong exercise session twice weekly for 8 weeks.

OUTCOME MEASURES

An investigator-designed questionnaire with seven items that were rated on a 1 to 6 scale, with higher scores indicating better results, and nine open-ended questions were used to obtain data on feasibility and acceptability. Adherence was calculated as the proportion of the 16 planned sessions attended.

RESULTS

Of the 45 older adults enrolled, 6 never started and 6 withdrew, with 33 evaluable at the end of the intervention. The mean age of the sample was 74.8 years; the majority were female (84.4%) and white (91.1%). Mean scores on aspects of difficulty, acceptability, suitability, or effectiveness of qigong exercise were all ≥5. Participants identified benefits of qigong exercise, such as calming and relaxing feelings, inner peace, better balance, and flexibility. Attendance rate was 78.8%, with 94% performing qigong exercise at least once weekly outside the class. All participants indicated that they would recommend qigong exercise to others. No adverse events occurred.

CONCLUSION

An 8-week qigong exercise program was feasible, acceptable, and safe for American older adults. Future robust randomized controlled trials are needed to confirm these findings.

Association of regular physical activity with total and cause-specific mortality among middle-aged and older Chinese: a prospective cohort study

Association between physical activity and mortality has rarely been investigated among the Chinese population. Furthermore, the most appropriate amount of physical activity for longevity benefits remains unclear. We used data from the Dongfeng-Tongji cohort, including 24,606 middle-aged and older retired adults in 2008 and followed to 2013, to quantify linear and non-linear dose-response relationships between regular physical activity and mortality risks by Cox proportional hazards model. Compared with participants who did not engage in regular physical activity, those performing regular physical activity had significantly 46%, 56%, and 49% decreased risks of mortality from all causes, circulatory, and respiratory diseases, respectively. Each one-SD increase in regular physical activity was associated with 32% decrease of respiratory disease mortality. There were significant nonlinear dose-response associations between regular physical activity and mortality from all causes and circulatory diseases. Mortality risks decreased monotonically with increased regular physical activity amount, and appeared to reach a threshold at around 100 MET-hours/week. More mortality benefits were found among non-smokers than that among current and former smokers. Our results suggest that middle-aged and older Chinese adults can achieve mortality benefits from regular physical activity at the WHO recommended minimum, and the benefit threshold appears at approximately 100 MET hours/week.

Physical activity and cognitive function among older adults in China: A systematic review

BACKGROUND

Physical activity (PA) has been shown to benefit cognitive function in older adults. However, the cognitive benefits of exercising for older Chinese adults have not been systematically documented. This study was to conduct a systematic review on evidence that PA is beneficial for cognitive functioning in older Chinese adults.

METHODS

Major databases, including PubMed, EMBASE, Cochrane Library, WanFang, CNKI, and VIP, were searched for studies published in English or Chinese between January 2000 and December 2015. Randomized and non-randomized controlled trials (RCTs and non-RCTs), cohort, case-control and cross-sectional studies that evaluated PA and cognitive function among older Chinese adults were included in this review.

RESULTS

Of 53 studies included and reviewed, 33 were observational (22 cross-sectional, 7 case-control, and 4 cohort) and 20 were experimental (15 RCTs, 5 non-RCTs). Observational studies showed an association of reduced risk of cognitive-related diseases (i.e., mild cognitive impairment, Alzheimer's disease, and dementia) through PA, whereas experimental studies reported exercise-induced improvement in multiple domains of cognitive function (i.e., global cognitive function, memory, executive function, attention, language, and processing recourse).

CONCLUSION

This systematic review provides initial evidence that PA may benefit cognition in older Chinese adults. Further studies of individuals with cognitive impairments and prospective and RCT studies having high scientific rigor are needed to corroborate the findings reported in this review.

Recruitment of older adults into randomized controlled trials: Issues and lessons learned from two community-based exercise interventions in Shanghai

BACKGROUND

With the increasing need for high-quality exercise interventions in China, relatively little is known about issues and challenges related to recruitment of older Chinese adults into exercise-based disease prevention interventions. This study aims to describe the recruitment process and outcomes of 2 exercise interventions conducted in Shanghai, China.

METHODS

Recruitment information was ascertained from 2 community-based randomized controlled trials for 2 exercise interventions, the first designed to improve health outcomes for older women with knee osteoarthritis and the second to study changes in cognitive function in adults with mild cognitive impairment. Results were summarized in terms of recruitment sources, number screened, screening-to-enrollment ratios, and costs.

RESULTS

Recruitment was primarily achieved through working with local residential divisions (i.e., neighborhood associations and residential committees). Both studies achieved their planned target number of older adults (45 and 46, respectively) within a 1-year time frame, with a screening-to-randomized ratio of 5:1 and demonstrated excellent retention rates (range 87%-93%) at 6 months. The recruitment cost for the 2 studies averaged RMB 189 (about USD 30) per initial recruit and RMB 738 (about USD 119) per participant randomized. Some major issues encountered during the recruitment process included (1) the use of community neighborhoods to support the conduct of the projects, (2) access to participants, and (3) feasibility.

CONCLUSION

Analysis of the 2 randomized controlled trials has provided valuable insights into the recruitment process and identified resources that can help better planning and recruitment for future interventions. Recommendations aimed at increasing the success of future recruitment efforts are provided.

Physical activity among older Chinese adults living in urban and rural areas: A review

With an increase in rural-to-urban migration, a rapidly aging population, and the rising risk of developing noncommunicable diseases in China, it is important to understand the epidemiology of physical activity (PA) and health in the context of disease prevention and population health. Despite its public health importance, there is a significant lack of knowledge about PA in older Chinese adults that may hamper primary prevention efforts of health promotion in an increasingly aging population. To fill this gap, this article presents a narrative review of PA in the older Chinese adult population with a special focus on residential settings (i.e., urban and rural). Using existing studies, the review examines overall PA patterns and their correlates and discusses public health implications and future research. Although there are some preliminary indications of urban and rural differences in PA in the aging population in China, continued research efforts are needed to facilitate primary prevention efforts aimed at reducing noncommunicable diseases and promoting an active lifestyle among the largest population of older people in the world.

Physical activity and health in the presence of China's economic growth: Meeting the public health challenges of the aging population

Three decades of rapid economic development in China have not only benefited millions of Chinese by improving their living standards but have also dramatically increased the number of people who are part of the country's aging population. However, economic growth has not been accompanied by sufficient attention given to important public health issues, including an increase in the incidence of chronic diseases and a decline in physical activity (PA) that comes with an aging population. The rapid growth in China's older population will soon exert an impact on the nation's economy, population health status, and health behaviors, and will increase stress on its healthcare system. This review article provides a broad perspective on the impact of rapid economic development, industrialization, and urbanization on health-related behaviors, with a specific focus on PA among older adults. Specifically, the article offers an overview of the demographic context, significant public health challenges, evidence on PA and exercise interventions, and knowledge gaps and future directions for research.