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Randomized Controlled Trial: Examining the Effects of Body and Mind Exercise Tai-Chi on Depressive Mood Symptoms, Psychological Resilience, and C-Reactive Protein Levels in Older Adults with Hypertension


Non-pharmacological approaches such as behavioral interventions are shown to reduce depression symptoms in older adults. Interventions that boost mental health could be an effective therapy to protect against or reduce depressive symptoms and inflammation factors in older adults. Studies showed that mind-body behavioral intervention like Tai-Chi (TC) may act as a therapy to reduce psychological stress and modulate the inflammation process and immune system where it can produce anti-inflammatory effects. The objective of this study is to examine the effects of a TC intervention versus a Healthy-Aging Education (HAE) classes in hypertensive older adults on depressive symptoms, resilience, and inflammation. Older adults (72.62 ± 7.09 years) were cluster-randomized to a 12-week TC intervention (N=102) or HAE classes (N=85). Baseline (V1) and post-intervention (V3) assessments included Beck Depression Inventory (BDI-II), Connor-Davidson Resilience Scale (CD-RISC), and inflammation level C-reactive protein (CRP). Linear mixed effects regression models were performed to examine if there was significant difference between the intervention group and comparison group. Post-hoc analysis was used to examine if TC and HAE classes had an independent effect on BDI-II, CD-RISC, and CRP levels from V1 to V3. The models were adjusted for age, sex, and class attendance. BDI-II scores decreased post-TC significantly (V1=7.41 ± 0.72; V3= 5.87 ± 0.86; Wald_F=11.794; p=0.001) and post- HAE classes (V1=6.73 ± 0.71; V3= 5.45 ± 0.64; Wald_F= 8.08; p=0.005). CD-RISC scores improved significantly post-TC intervention (V1=31.3 ± 6.25; V3= 33.5 ± 5.2; Wald_F= 14.691; P<0.001) and post HAE classes (V1= 32.20 ±5.99; V3= 33.10 ± 6.31; Wald_F=8.151; p=0.004). Plasma CRP levels remained unchanged post-TC intervention (V1= 5.40 ± 0.78; V3= 5.36 ± 0.90; Wald_F=0.072; p= 0.789), and post HAE (V1= 6.65 ± 0.90, V3= 6.12 ± 0.95; Wald_F=0.844; p=0.359).Therefore, when each group was examined independently, there was visit-by-visit group interaction at V3 in relation to V1 for BDI-II and CD-RISC, but not for CRP levels. However, when both groups were examined simultaneously, there were no significant interaction effect between the TC intervention and HAE comparison group from V1 to V3 for depressive mood symptoms (t= - 0.333; p=0.740), resilience (t= 0.585; p=0.559), and CRP levels (t= -0.573; p=0.637). It is possible that the 12-weeks of TC was not sufficient to observe significant improvement in the depressive mood symptoms, resilience, and CRP levels among the hypertensive older adults. Thus, future studies are needed to test this hypothesis.

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