Effects of a traditional Chinese mind-body exercise, Baduanjin, on the physical and cognitive functions in the community of older adults with cognitive frailty: study protocol for a randomised controlled trial

Effects of Baduanjin exercise on cognitive frailty, oxidative stress, and chronic inflammation in older adults with cognitive frailty: a randomized controlled trial

Background

Oxidative stress and chronic inflammation play an important role in the pathogenesis process of cognitive frailty (CF). Regular Baduanjin exercise could improve cognitive frailty in older adults, but it is unclear whether the effect of Baduanjin exercise on improving CF is mediated by modulating circulating oxidative stress and inflammatory process.

Method

A total of 102 community-dwelling older adults with CF were recruited and randomly allocated into a 24-week Baduanjin exercise training group or no specific exercise intervention control group at an equal rate. Cognitive function and physical frailty index were assessed using the Montreal Cognitive Assessment (MoCA) and the Edmonton Frail Scale (EFS), as well as the oxidative stress and inflammatory cytokines were measured at baseline and after intervention.

Result

After 24 weeks of intervention, the increased MoCA score (2.51 ± 0.32 points, p < 0.001) and the decreased EFS scores (1.94 ± 0.20 points, p = 0.012) in the Baduanjin group were significantly higher than those in the control group. Serum antioxidant SOD levels were increased by 10.03 ± 4.73 U/mL (p < 0.001), and the prooxidative MDA and 8-iso-PGF2α levels were decreased by -1.08 ± 0.80 nmol/mL (p = 0.030) and -86.61 ± 15.03 ng/L (p < 0.001) in the Baduanjin training group; while inflammatory cytokines IFN-γ, IL-2 and IL-4 levels were increased (1.08 ± 0.33 pg./mL, p = 0.034, 2.74 ± 0.75 pg./mL, p = 0.04 and 1.48 ± 0.35 pg./mL, p = 0.042). In addition, a mediation effect that Baduanjin training improved cognitive ability mediated by an increase of circulating IFN-γ and IL-2 levels were observed in this study.

Conclusion

Regular Baduanjin exercise training could improve the cognitive frailty of the community-dwelling older adults with CF, and modulate oxidative stress and inflammatory processes by reducing circulating pro-oxidative MDA and 8-iso-PGF2α levels and increasing anti-oxidative SOD levels, as well as impacting inflammatory cytokines IFN-γ, IL-2, and IL-4 levels. Nevertheless, the mechanism of Baduanjin exercise mediating oxidative stress and inflammatory processes should be cautious to be explained.

Clinical trial registration

http://www.chictr.org.cn/index.aspx, ChiCTR1800020341.

Baduanjin is Better Balance Training Compared to Walking: A Cross-Sectional Study Based on Center of Gravity Trajectories

BACKGROUND

 It has already been demonstrated by previous studies that Baduanjin training can improve the body's balance. However, its biomechanical mechanism remains unknown. Center of gravity (COG) trajectory analysis is an essential biomechanical test to explore the balance ability of the human body. Previous studies have not used the COG trajectory analysis technique to research Baduanjin training. The study utilizes COG trajectory analysis to analyze the trajectory of COG during Baduanjin training and compare it with that of walking, which is a common exercise for improving balance and aerobic ability, to determine if Baduanjin exercises affect the COG more than walking.

MATERIALS AND METHODS

 Eight healthy female college students performed the walking and the eight forms of Baduanjin, a total of nine motions. The lower body kinematics were captured by the Vicon Motion Capture and Analysis System, while the kinetic data were acquired by the Kistler 3D Force Platform. The data were imported into Visual 3D to process the trajectory of the COG displacement amplitude, velocity, and acceleration of each motion. The COG horizontal envelope areas were calculated by Origin 9.0 Software (Origin Lab, Northampton, Massachusetts, USA) .

RESULTS

Specific motions of Baduanjin provided significantly higher COG displacement amplitude, velocities, and acceleration training than walking. The F2 and F5 motions could provide a larger COG horizontal envelope area than walking. On the x-axis, F2 provided a greater COG displacement amplitude than walking, F1, F2, and F5 provided greater velocities, while all the motions provided greater accelerations. On the y-axis, all the motions except F2 provided greater COG displacement velocities and accelerations than walking. On the z-axis, F1-7 provided a greater COG displacement amplitude than walking, all the motions provided greater velocities, while all the motions except F2 provided greater accelerations.

CONCLUSION

Baduanjin training provides a more intense COG perturbation than walking, which may be a more challenging balance training than walking.

Anthropometric measures and physical examination could be used to assess phenotypic GLIM (Global leadership initiative on malnutrition) criteria in heart failure patients

BACKGROUND AND AIMS

The assessment of muscle mass using technology-based methods is less commonly performed when applying the Global Leadership Initiative on Malnutrition (GLIM) criteria due to the lack of skilled clinical nutrition practitioners and/or equipment. Based on the predictive validity of poor health outcomes and feasibility in clinical practice, this study aimed to analyze whether the measurement of calf circumference (CC), mid-upper arm circumference (MAC), and the physical examination could be used as substitutes for muscle mass assessment, as well as handgrip strength (HGS) used as a substitution when applying the GLIM criteria in hospitalized HF patients.

METHODS AND RESULTS

From June 2022 to January 2023, a single-center prospective study including 216 patients was performed. Additionally, covariates were identified by a directed acyclic graph. The multivariate logistic regression analysis was also used to analyze and compare the association between poor health outcomes and malnutrition (based on 5 types of GLIM criteria). Cohen-kappa coefficient and TELOS-feasibility score were calculated. The prevalence of malnutrition ranged from 35.2% to 42.6%, depending on the tool used. After adjusting for covariates, malnutrition assessed using CC, MAC, or physical examination within the GLIM criteria was independently associated with poor clinical outcomes (90-day HF-related readmission or all-cause mortality and prolonged hospital stay) but not with HGS.

CONCLUSION

CC, MAC and results from physical examination but not HGS may serve as a substitutive metric of muscle mass contained in the GLIM criteria to diagnose malnutrition and predict poor clinical outcomes among HF patients.

REGISTRATION NUMBER

This study was registered at Chinese Clinical Trial Registry. (ChiCTR2200057876) on 20 Mar. 2022.

Effect of a Baduanjin intervention on the risk of falls in the elderly individuals with mild cognitive impairment: a study protocol for a randomized controlled trial

BACKGROUND

Falls are a global public problem and may be an important cause of death in older adults. However, older adults with mild cognitive impairment(MCI) are more likely to fall and suffer more damage than older adults with normal cognitive function, which shows the importance of preventing falls. More and more evidence shows that Baduanjin can improve the balance function of the elderly and reduce the risk of falls in the elderly with MCI, but the mechanism is still unclear. The main purpose of this study is to verify the intervention effect of Baduanjin training on the risk of falls in elderly people with MCI and to elucidate the underlying mechanism of Baduanjin training in reducing the risk of falls in MCI patients.

METHODS

In this prospective study, outcome assessor-blind, three-arm randomized controlled trial, a total of 72 eligible participants will be randomly allocated (1:1:1) into the 12-week Baduanjin exercise intervention (60 min per session, three sessions per week), the 12-week brisk walking group(60 min per session, three sessions per week) or the 12-week health education group. Primary outcome is the Fall-Risk Self-Assessment Questionnaire(FRQ), and secondary outcomes are fall efficacy index, gait assessment, balance function, lower limb muscle strength, cognitive function, activities of daily living(ADL) and MRI scans. In addition to the MRI scans, which will be measured before and after the intervention,other primary and secondary outcomes will be assessed at baseline, 6 weeks, and 12 weeks (at the end of the intervention) and after an additional 12-week follow-up period. The mixed linear model will be conducted to observe the intervention effects.

DISCUSSION

This trial will investigate the effect of Baduanjin exercise on the prevention of falls in elderly individuals with MCI, explore the imaging mechanism of Baduanjin exercise to reduce the risk of falls in elderly individuals with MCI from the perspective of vestibular neural network, and provide strong evidence for Baduanjin exercise to reduce the risk of falls in elderly individuals with MCI, as well as provide new ideas and approaches for the central mechanism of Traditional Chinese Medicine(TRC) rehabilitation methods to intervene in falls in elderly.

TRIAL REGISTRATION

Chictr.org.cn, ID: ChiCTR2200057520. Registered on 14 March 2022, https://www.chictr.org.cn/showproj.html?proj=146592 .

CNN-LSTM Model for Recognizing Video-Recorded Actions Performed in a Traditional Chinese Exercise

Identifying human actions from video data is an important problem in the fields of intelligent rehabilitation assessment. Motion feature extraction and pattern recognition are the two key procedures to achieve such goals. Traditional action recognition models are usually based on the geometric features manually extracted from video frames, which are however difficult to adapt to complex scenarios and cannot achieve high-precision recognition and robustness. We investigate a motion recognition model and apply it to recognize the sequence of complicated actions of a traditional Chinese exercise (ie, Baduanjin). We first developed a combined convolutional neural network (CNN) and long short-term memory (LSTM) model for recognizing the sequence of actions captured in video frames, and applied it to recognize the actions of Baduanjin. Moreover, this method has been compared with the traditional action recognition model based on geometric motion features in which Openpose is used to identify the joint positions in the skeletons. Its performance of high recognition accuracy has been verified on the testing video dataset, containing the video clips from 18 different practicers. The CNN-LSTM recognition model achieved 96.43% accuracy on the testing set; while those manually extracted features in the traditional action recognition model were only able to achieve 66.07% classification accuracy on the testing video dataset. The abstract image features extracted by the CNN module are more effective on improving the classification accuracy of the LSTM model. The proposed CNN-LSTM based method can be a useful tool in recognizing the complicated actions.

Effects of traditional Chinese mind–body exercises on older adults with cognitive impairment: A systematic review and meta-analysis

Objective

To determine the effectiveness of traditional Chinese mind–body exercises in improving cognition, memory, and executive function in older adults with cognitive impairment.

Data sources

Relevant English and Chinese language studies published until September 14th, 2022 were retrieved from PubMed, Web of Science, Cochrane Library, Embase, CINAHL, WAN FANG DATA, VIP Information, CNKI, and SinoMed databases.

Review methods

Randomized controlled trials assessing traditional Chinese mind–body exercises (Tai Chi, Baduanjin, Qigong, Mind–Body Therapies, and Yijinjing) in older adults with cognitive impairment were included. Two researchers independently identified eligible studies and extracted data. A risk-of-bias assessment was performed using the Cochrane Risk of Bias Tool.

Results

This study included 15 randomized controlled trials (1,127 participants) from China, Thailand and American. Most studies had a high risk of bias in the blinding of participants and researchers, one study had a high risk of bias in the random sequence generation and two studies had a high risk of bias in the incomplete outcome data. Compared with conventional therapy alone, traditional Chinese mind–body exercises significantly improved global cognitive function (p &lt; 0.00001), and Baduanjin could improve the global cognitive function (p &lt; 0.00001), memory function (p &lt; 0.0001), and executive function (p &lt; 0.0001) outcomes after treatment, and significantly improved some dimensional scores on the auditory verbal learning test after treatment (p = 0.04).

Conclusion

Compared with conventional therapy, traditional Chinese mind–body exercises (Tai Chi, Baduanjin, and Qigong) significantly improved global cognitive function, and Baduanjin could improve global cognitive function, memory function, and executive function in older adults with cognitive impairment.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, CRD42022327563.

Effect of Baduanjin exercise on cerebral blood flow and cognitive frailty in the community older adults with cognitive frailty: A randomized controlled trial

Objectives

Regular Baduanjin exercise training has been shown to be beneficial to the physical and cognitive health of older adults, but the underlying mechanisms remain to be investigated. This study examined the influence of Baduanjin on cerebral hemodynamics in community-dwelling older adults with cognitive frailty.

Design

Randomized controlled trial.

Methods

A total of 102 eligible participants were randomly allocated into the Baduanjin exercise intervention group (BEG) or usual physical activity control group (CG) for 24 weeks. Cerebral hemodynamic parameters of bilateral middle/anterior cerebral artery and basilar artery, cognitive ability and physical frailty were assessed using Transcranial Doppler (TCD), Montreal Cognitive Assessment (MoCA) and Edmonton Frailty Scale (EFS) at baseline and 24 weeks post-intervention.

Results

After 24 weeks intervention, the changes in peak systolic velocity (PSV), mean blood flow velocity (MBFV), and end diastolic velocity (EDV) in the right middle cerebral artery and basilar artery were better in the BEG than in the CG; the increase in MoCA scores and the decrease in EFS scores were significantly higher in the BEG than in the CG. Moreover, the interaction of exercise and time on those variables showed obvious significance.

Conclusions

The 24 weeks Baduanjin exercise training had a positive beneficial effect on cerebral blood flow in community-dwelling older adults with cognitive frailty. This may be a potential mechanism by which Baduanjin exercise improves the cognitive frailty in older adults.

Trial registration

Chinese Clinical Trial Registry, ChiCTR1800020341.

Date of registration

December 25, 2018, http://www.chictr.org.cn/showproj.aspx?proj=29846.

Baduanjin exercise modulates the hippocampal subregion structure in community-dwelling older adults with cognitive frailty

Background

Regular Baduanjin exercise intervention was proven to be beneficial in improving the cognitive ability and physical performance of older adults with different health conditions but was unclear to influence the structural plasticity of the hippocampus. This study aimed to explore the modulation of hippocampal subregions as a mechanism by which Baduanjin exercise improves cognitive frailty in older adults.

Methods

A total of 102 community-dwelling older adults with cognitive frailty were recruited and randomly allocated to the Baduanjin exercise training group and usual physical activity control group. The participants in the Baduanjin exercise training group participated in a 24-week Baduanjin exercise intervention program with an exercise frequency of 60 min per day, 3 days per week. Cognitive ability and physical frailty were assessed, and MRI scans were performed on all participants at baseline and after 24 weeks of intervention. The structural MRI data were processed with MRIConvert (version 2.0 Rev. 235) and FreeSurfer (version 6.0.0) software. Data analyses were performed using the independent sample t tests/Mann-Whitney U tests with the Bonferroni correction, mixed linear model, correlation, or mediation analysis by the SPSS 24.0 software (IBM Corp, Armonk, NY, United States).

Results

After 24 weeks of intervention, a statistically significant increase was found for the Montreal Cognitive Assessment (MoCA) scores (p = 0.002) with a large effect size (Cohen's d = 0.94) and the significant interaction effect (P _{goup × time} < 0.05), Memory Quotient (MQ) scores (p = 0.019) with a medium effect size (Cohen's d = 0.688) and the significant interaction effect (P _{goup × time} < 0.05), and other parameters of WMS-RC test including pictures (p = 0.042), recognition (p = 0.017), and association (p = 0.045) test with a medium effect size (Cohens' d = 0.592, 0.703, and 0.581) for the Baduanjin training group, while significant decrease for the Edmonton Frailty Scale (EFS) score (p = 0.022), with a medium effect size (Cohen's d = -0.659) and the significant interaction effect (P _{goup × time} < 0.05) for the Baduanjin training group. The differences in the left parasubiculum, Hippocampal Amygdala Transition Area (HATA), right Cornu Ammonis Subfield 1 (CA1) and presubiculum volumes from baseline to 24 weeks after intervention in the Baduanjin training group were significantly greater than those in the control group (p < 0.05/12). Further analysis showed that the changes in right CA1 volume were positively correlated with the changes in MoCA and MQ scores (r = 0.510, p = 0.015; r = 0.484, p = 0.022;), the changes in right presubiculum and left parasubiculum volumes were positively correlated with the changes in MQ (r = 0.435, p = 0.043) and picture test scores (r = 0.509, p = 0.016), respectively, and the changes in left parasubiculum and HATA volumes were negatively correlated with the changes in EFS scores (r = -0.534, p = 0.011; r = -0.575, p = 0.005) in the Baduanjin training group, even after adjusting for age, sex, years of education and marital status; furthermore, the volume changes in left parasubiculum and left HATA significantly mediated the Baduanjin exercise training-induced decrease in the EFS scores (β = 0.376, 95% CI 0.024 ~ 0.947; β = 0.484, 95% CI 0.091 ~ 0.995); the changes of left parasubiculum and right CA1 significantly mediated the Baduanjin exercise training-induced increase in the picture and MO scores (β = -0.83, 95% CI-1.95 ~ -0.002; β = -2.44, 95% CI-5.99 ~ -0.32).

Conclusion

A 24-week Baduanjin exercise intervention effectively improved cognitive ability and reduced physical frailty in community-dwelling older adults with cognitive frailty, and the mechanism might be associated with modulating the structural plasticity of the hippocampal subregion.

A study protocol for a randomized controlled trial to assess the efficacy of Baduanjin exercise on older adults with sarcopenia in China

Background

Accompanied by the decline of physiological functions, the decrease of physical activity, and comorbidities, older adults are susceptible to sarcopenia because of accelerated loss of muscle mass. Resistance training is recommended by different clinical practice guidelines. However, most older adults have difficulty in taking recommended high-load resistance training programs, and there are limited exercise options form them. Baduanjin, a traditional Chinese mind-body exercise with relatively low intensity and simple movements, has the potential benefits of improving physical functions and may be feasible in treating sarcopenia and preventing its adverse health outcomes in older patients. With the emergence of the concept of gut-muscle axis, this study aims to determine the efficacy of Baduanjin exercise on Chinese older adults with sarcopenia and explore its underlying mechanism.

Methods

This is a 24-week, assessor-blinded, randomized controlled trial. Individuals aged 60 to 84 years old will be screened for sarcopenia. 90 participants with sarcopenia will be enrolled and randomly assigned (1:1) into the Baduanjin exercise or resistance training group, and 20 participants without sarcopenia will be set as the non-sarcopenia control group. The primary outcome is the scores of Short Physical Performance Battery. The secondary outcomes are body composition, handgrip strength, walking speed, global cognitive function, and incidence of falls. These outcomes will be assessed at baseline, the 12th week and the 24th week. While stool samples from participants will be collected at baseline and the 24th week for analyzing the abundance of gut microbiome. Data will be analyzed in an intention-to-treat protocol.

Discussion

The results of this study will determine whether Baduanjin exercise can be an alternative non-pharmacological approach for older adults with sarcopenia. If they can show positive significance, it will promote Baduanjin exercise in clinical practice among these patients and inform further research involving exercise interventions on the optimal types, timing, and intensity to ameliorate sarcopenia for elderly people.

Trial registration

Chinese Clinical Trial Registry; Registration number: ChiCTR2100051871; Prospectively registered on October 8th, 2021.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-022-03778-9.

Effects of Baduanjin imagery and exercise on cognitive function in the elderly: A functional near-infrared spectroscopy study

Objective

Cognitive function is essential in ensuring the quality of life of the elderly. This study aimed to investigate the effects of Baduanjin imagery and Baduanjin movement (a traditional Chinese health exercise, TCHE) on cognitive function in the elderly using functional near-infrared spectroscopy (fNIRS).

Methods

72 participants with a mean age of 66.92 years (SD = 4.77) were recruited for this study. The participants were randomly assigned to three groups: the Baduanjin imagery, the Baduanjin exercise, and the Control. Stroop task was used to record the accuracy and reaction times, and a near-infrared spectral brain imaging system was used to monitor the brain's oxy-hemoglobin concentration responses.

Results

(1) For the reaction times of Stroop incongruent tasks, the main effect of the test phase (F = 114.076, p < 0.001) and the interaction effect between test phase and group (F = 10.533, p < 0.001) were all significant. The simple effect analysis further demonstrated that the reaction times of the Baduanjin imagery group and Baduanjin exercise group in the post-test was faster than that in the pre-test (ps < 0.001); (2) Analysis of fNIRS data showed the significant interaction effect (F = 2.554, p = 0.013) between the test phase and group in the left dorsolateral prefrontal cortex. Further analysis showed that, during the post-test incongruent tasks, the oxy-Hb variations were significantly higher in participants of the Baduanjin imagery group (p = 0.005) and Baduanjin exercise group (p = 0.002) than in the control group; For the right inferior frontal gyrus, the interaction between the test phase and group was significant (F = 2.060, p = 0.044). Further analysis showed that, during the post-test incongruent tasks, the oxy-Hb variations were significantly higher in participants of the Baduanjin imagery group than in the control group (p = 0.001).

Conclusion

Baduanjin imagery and exercise positively affect cognitive performance; Baduanjin imagery and exercise activated the left dorsolateral prefrontal cortex; Baduanjin imagery activated the right inferior frontal gyrus, while Baduanjin exercise could not.

Automated assessment of balance: A neural network approach based on large-scale balance function data

Balance impairment (BI) is an important cause of falls in the elderly. However, the existing balance estimation system needs to measure a large number of items to obtain the balance score and balance level, which is less efficient and redundant. In this context, we aim at building a model to automatically predict the balance ability, so that the early screening of large-scale physical examination data can be carried out quickly and accurately. We collected and sorted out 17,541 samples, each with 61-dimensional features and two labels. Moreover, using this data a lightweight artificial neural network model was trained to accurately predict the balance score and balance level. On the premise of ensuring high prediction accuracy, we reduced the input feature dimension of the model from 61 to 13 dimensions through the recursive feature elimination (RFE) algorithm, which makes the evaluation process more streamlined with fewer measurement items. The proposed balance prediction method was evaluated on the test set, in which the determination coefficient (R2) of balance score reaches 92.2%. In the classification task of balance level, the metrics of accuracy, area under the curve (AUC), and F1 score reached 90.5, 97.0, and 90.6%, respectively. Compared with other competitive machine learning models, our method performed best in predicting balance capabilities, which is especially suitable for large-scale physical examination.

Exercise interventions for older people with cognitive frailty-a scoping review

Background

As the global population ages, the issue of frailty in older people is gaining international attention. As one of the major subtypes of frailty, cognitive frailty is a heterogeneous clinical manifestation characterised by the co-existence of physical decline and cognitive impairment. The occurrence of cognitive frailty increases the risk of adverse health outcomes in older people, affecting their daily functioning and quality of life. However, cognitive frailty is a reversible state, and many interventions have been explored, with exercise interventions playing an important role in the non-pharmacological management of cognitive frailty. This study describes and summarises current exercise interventions for older people with cognitive frailty (including parameters such as mode, frequency and duration of exercise) and identifies the limitations of existing studies to inform future exercise interventions for older people with cognitive frailty.

Methods

Using a scoping review approach, Chinese and English literature published in PubMed, Web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Database, China Biomedical Literature Database (SinoMed) and Vipshop from April 2013, when the definition of cognitive frailty first appeared, to August 2021 was searched to select studies related to exercise interventions for this group, extract information from the included literature, and summarise and report the findings.

Results

Nine RCT trial studies and one quasi-experiment study were included, for a total of 10 articles. The exercise modalities involved walking, brisk walking, Otago exercise, resistance exercise, balance training, flexibility training and Baduanjin, etc.; the intensity of exercise was based on individualised guidance and graded exercise intensity; the frequency of exercise was mostly 3–4 times/week; the duration of exercise was mostly 30–60 min/time; compared to the control group, the included studies showed statistically significant improvements in cognitive function, frailty status, and depression with the exercise intervention.

Conclusion

There is a paucity of evidence on exercise interventions for older people with cognitive frailty. The evidence provided in this study suggests that exercise interventions may be beneficial for older people with cognitive frailty. However, the existing studies suffer from small sample sizes, short intervention periods, inadequate monitoring of the entire exercise process, and non-uniformity in the assessment of exercise effects. More randomized controlled trials should be conducted in the future to explore the most effective, low-cost and simple interventions to meet the needs of the older people with cognitive frailty.

Global Research on Cognitive Frailty: A Bibliometric and Visual Analysis of Papers Published during 2013–2021

This study analyzed the current status, hotspots, and emerging trends of global research on cognitive frailty, in order to provide new research ideas for researchers. Articles and reviews related to cognitive frailty, published from 2013 to 2021, were retrieved from the Web of Science Core Collection (WoSCC) database on 26 November 2021. CiteSpace 5.8.R3 was employed for data analyses. A total of 2077 publications were included. There has been a rapid growth of publications on cognitive frailty research since 2016. The United States, Italy, England, and Australia have been the leading research centers of cognitive frailty; however, China has also recently focused on this topic. The National Center for Geriatrics and Gerontology, and Shimada H. were found to be the most prolific institution and author, respectively. Co-citation analysis identified 16 clusters, of which the largest was cognitive frailty. The keywords which occurred most frequently were “older adult”, followed by “cognitive impairment”, “frailty”, “risk”, “dementia”, “prevalence”, “mortality”, “health”, and “Alzheimer’s disease”. Burst keyword detection revealed a rising interest in cognitive frailty models. By analyzing these publications from recent years, this study provides a comprehensive analysis of cognitive frailty research.

Effects of tai chi and Qigong on cognition in neurological disorders: A systematic review and meta-analysis

OBJECTIVES

To explore whether tai chi and Qigong can improve cognitive function in patients with neurological disorders.

METHODS

The PubMed, Embase, Cochrane Central Register of Controlled Trials, SinoMed Database, Chinese National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (VIP) databases were searched from inception to December 24, 2021. The methodological quality of the included studies was evaluated according to the Cochrane Handbook for Systematic Reviews of Interventions criteria.

RESULTS

This study included 2,754 participants from 40 randomized controlled trials (RCT)s with low to high methodological quality. Analysis of active and non-active comparisons showed significant effects for tai chi/Qigong (P<0.05) on global cognitive function, executive function, memory, visuospatial ability, and cognitive processing speed.

CONCLUSIONS

Tai chi and Qigong were effective interventions to improve cognition in patients with Parkinson's disease, stroke, mild cognitive impairment, dementia, and traumatic brain injury; however, no RCTs were performed for other neurological disorders.

An update on cognitive frailty: Its definition, impact, associated factors and underlying mechanisms, and interventions

Since the concept and operational definition of "cognitive frailty" (simultaneous presence of physical frailty and cognitive impairment without concurrent dementia) were proposed by the International Academy of Nutrition and Aging and the International Association of Gerontology and Geriatrics, cognitive frailty has been widely investigated. This review is intended to address the operational definition of cognitive frailty, its consequences, contributing factors and underlying mechanisms, as well as interventions for cognitive frailty. Although the definitions and assessments of cognitive frailty vary among researchers, older adults with both physical frailty and cognitive impairment are shown to be at higher risk of adverse health outcomes, including death, disability, hospitalization and incident dementia, than those with either condition alone. While the underlying mechanisms of cognitive frailty are still unclear, factors shown to be associated with cognitive frailty include sociodemographic factors, social status, nutritional status, geriatric syndrome, physical and cognitive activities, functional status, comorbidities, medication use, gut-derived metabolites and structural changes in the brain. Accumulating evidence indicates the need for comprehensive geriatric assessment that helps identify the possible causes of cognitive frailty and develop a multimodal individualized intervention to prevent adverse health outcomes for older adults with cognitive frailty. Further studies are required to clarify the mechanisms through which physical frailty and cognitive impairment interact to accelerate adverse health outcomes, particularly cognitive outcomes. In addition, for older adults with cognitive frailty, an effective flow diagram from primary screening through comprehensive assessment to multidimensional intervention needs to be developed for future implementation in both clinical and community settings. Geriatr Gerontol Int 2021; ••: ••-••.

New Frontiers in the Prevention, Diagnosis, and Treatment of Alzheimer's Disease

One of the major puzzles in medical research and public health systems worldwide is Alzheimer's disease (AD), reaching nowadays a prevalence near 50 million people. This is a multifactorial brain disorder characterized by progressive cognitive impairment, apathy, and mood and neuropsychiatric disorders. The main risk of AD is aging; a normal biological process associated with a continuum dynamic involving a gradual loss of people's physical capacities, but with a sound experienced view of life. Studies suggest that AD is a break from normal aging with changes in the powerful functional capacities of neurons as well as in the mechanisms of neuronal protection. In this context, an important path has been opened toward AD prevention considering that there are elements of nutrition, daily exercise, avoidance of toxic substances and drugs, an active social life, meditation, and control of stress, to achieve healthy aging. Here, we analyze the involvement of such factors and how to control environmental risk factors for a better quality of life. Prevention as well as innovative screening programs for early detection of the disease using reliable biomarkers are becoming critical to control the disease. In addition, the failure of traditional pharmacological treatments and search for new drugs has stimulated the emergence of nutraceutical compounds in the context of a "multitarget" therapy, as well as mindfulness approaches shown to be effective in the aging, and applied to the control of AD. An integrated approach involving all these preventive factors combined with novel pharmacological approaches should pave the way for the future control of the disease.

Effect of baduanjin on the fall and balance function in middle-aged and elderly people: A protocol for systematic review and meta-analysis

BACKGROUND

The risk of fall seriously affects the health and quality of life of the middle-aged and elderly people, especially the injury and disability caused by fall of the middle-aged and elderly people, which imposes a huge burden on family and social medical care. Baduanjin exercise may be an effective intervention to enhance the muscle strength and stability of lower limbs, improve the balance ability and gait of middle-aged and elderly people, reduce the incidence of falls, improve the quality of life, and promote the health of middle-aged and elderly people. The aim of this study is to summarize evidence and systematically review the efficacy and safety of Baduanjin on the fall and balance function in middle-aged and elderly people.

METHODS

We conducted a systematic search of English and Chinese RCTs in the following 8 electronic databases: PubMed, EMBASE, Web of Science, The Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database, from their respective dates of inception to July 2021. Other resources will be searched if necessary. The primary outcome is the fall rate in middle-aged and elderly people and the secondary outcomes include the Single-Leg Standing (SLS) Test, Berg Balance Scale (BBS), Timed Up and Go (TUG) Test. The study selection, data extraction, risk of bias, data synthesis and analysis, reporting biases, and the quality of evidence will be independently conducted by 2 reviewers who use the EndNote X9 software, Cochrane handbook assessment tool, RevMan 5.3 software, a funnel plot and GRADE system.

RESULTS

This study will evaluate the effect of Baduanjin on falls and balance function of middle-aged and elderly people from multiple outcome evaluation indicators such as fall rate, and provide high-quality evidence.

CONCLUSION

This study will provide evidence for whether Baduanjin has an effect on falls and balance function in middle-aged and elderly people.

ETHICS AND DISSEMINATION

Ethics approval is not required for systematic review, since it does not infringe on personal interests. The results will be submitted to peer-review journals or disseminated at scientific conferences.

The effect of health-care Qigong Baduanjin combined with auricular point sticking on athletes' pre-competition anxiety: A protocol for systematic review and meta-analysis

BACKGROUND

Competition anxiety is also known as pre-competition anxiety (PCA), because this anxiety state often occurs before the athletes face the competition. If it is not adjusted in time, which will greatly affect the performance of athletes, even the mental health and physical health of athletes. Therefore, the selection of appropriate methods to intervene the athletes, reducing the PCA of athletes, and it has an important effect on the competition performance of athletes. Therefore, based on the basic theory of traditional Chinese medicine and sports psychology principles, this study adopts a way of systematic evaluation to study the effect of health-care Qigong Baduanjin (HCQB) combined with auricular point sticking (APS)in the treatment of athletes' PCA (APA), the purpose is to help the majority of athletes to eliminate the PCA.

METHODS

Two searchers independently retrieve CNKI, WANFANG databases, VIP, CBM, Web of Science, Embase, PubMed, The Cochran Library and other Chinese and English databases. It is supplemented by manual retrieval to comprehensively collect the relevant literature data of the clinical controlled study of HCQB combined with APS in the treatment of APA. The retrieval time is from January 1, 1990 to October 1, 2020, using the subject word and keywords to retrieve, developing a retrieval style according to the characteristics of the database. The two evaluators independently use the above-mentioned retrieval methods to retrieve the main literature database, summarizing and removing the duplicate literature, then reading the title and abstract of the literature separately, excluding the literature that clearly does not meet the inclusion criteria, and finally reading the literature, and finally including the literature in line with the study, in case of disagreement, with the third researcher to decide. The quality evaluation of the literature is independently evaluated using the bias risk assessment criteria for randomized controlled trials in Cochrane Manual 5.1.0. Using the RevMan 5.3 software for meta-analysis.

RESULTS

This study will study the effect of HCQB combined with APS on reducing APA, and the results of the study will be published in high-impact academic journals.

CONCLUSION

The quality of athletes' mental state is related to whether athletes can play their true level of sports in the competition, and good mental state is also the prerequisite to ensure that athletes get better results. The conclusions reached by this study will provide quantifiable reference for coaches and athletes, with the aim of providing theoretical basis for helping the athletes eliminate PCA.

ETHICS AND DISSEMINATION

The type of this study belongs to the category of systematic evaluation, the data in this study are derived from published research papers and public data in the Internet, so ethical review is not suitable for this study.

PROSPERO REGISTRATION NUMBER

2021 CRD42021228254.