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Psychological - Cognitive

This document contains information about recent research on the effectiveness of qigong and/or taiji (or tai chi) in improving people’s psychological and cognitive health. The first section is our summary of all the studies we found on qigong and/or taiji interventions focusing on psychological and cognitive health. We believe that qigong and taiji have very similar benefits. We believe the terms are interchangeable. The sections that follow are the individual studies that make up the summary.

Cognitive Health
From December 2018 through March 2022, 13 articles were published regarding the effectiveness of qigong and or tai chi in treating mild cognitive impairment or improving intact cognitive functioning. Over 17,000 middle aged to elderly adults took part in the studies which measured the capacity for visual and spatial awareness, learning, memorization, manipulating information, reasoning and verbalization.

Findings include:
● Significantly increased cognition scores doing moderate intensity mind-body exercises practiced from 60 to 120 minutes per week.
● Lasting effects of at least 12 weeks when tai chi practiced 3 times a week for 30 to 60 minutes per session.
● Moderate to significant improvements in cognitive function found in most of the studies.

Psychological Health
Between March 2019 and February 2022, 6 articles were published regarding the effectiveness of qigong and or tai chi in the treatment of anxiety, depression and or negative emotions.

Over 4,730 participants from adolescents to both young and older adults were evaluated with some studies lasting up to 13 years.

Findings include:
● Most significant improvement in cancer, stroke and heart attack participants.
● Improved depression in both young and older adults practicing tai chi though older adults showed greater improvement.
● Potential improvement, positive improvement to significant improvement from the practice of qigong or tai chi.

Cognitive and Psychological  Health
During 2019-2022 there were 13 systematic reviews on Cognitive Impairment.  Eleven of these studies showed that the intervention showed mild to moderate improvement in mild cognitive impairment.

● Twenty seven random control studies found Baduanjin (Eight brocades) most advantageous in promoting cognitive functions.
● Cognitive flexibility and function, working memory, verbal fluency, visuospatial ability, executive functions, physical activity, semantic memory, self-perception of memory, and learning was significantly improved in both intact or impaired older adults.
● Nine studies showed overall cognition for people with mild cognitive impairment are about the same as for people who exercise.
● Twenty three studies show qigong as superior to exercise.
● Qigong and/or taiji may be effective for alleviating depression symptoms in individuals with major depressive disorder, especially for patients with cancer, stroke, and heart failure.
● Qigong and/or taiji caused significant improvement in negative emotions in young adults and seniors, but seniors benefited more.
● Adolescents had reduction in anxiety and depression symptoms as well as reducing cortisol (stress hormone).
● Improvements can last at least 12 weeks with a frequency of three times a week practice and 30-60 minutes per session.  Longer duration was not associated with larger effects.

Qigong is a safe way to bring better changes in cognitive function score.  Although Qigong is effective in mental health, it is not a substitute for psychological treatment.  Due to the extraordinary global impact of COVID and mass shootings, mental health support is critical.


Study 1
Li, et al, revealed the effectiveness of traditional Chinese exercises for improving global  cognition in adults with cognitive impairment. Twenty-seven random control studies were  reviewed with a total of 2,414 participants involved. The authors reported that significant  benefits for all traditional Chinese exercises were found with improved cognitive function in  elderly individuals with cognitive impairment. The four types of traditional Chinese exercises  were ranking based on their respective advantages in promoting cognition. Baduanjin (also  known as Eight Brocades) was the most advantageous in terms of promoting cognitive  functions.

Effects of traditional Chinese exercise on patients with cognitive impairment: A  systematic review and Bayesian network meta-analysis.
Li C, Zheng D, Luo J.
Nurs Open. 2021 Sep;8(5):2208-2220. doi: 10.1002/nop2.799. Epub 2021 Feb 19.PMID:  33605528  


Study 2
Wu, et al, reviewed 32 randomized controlled trials with 3624 participants. Mind-body  exercises improved global cognition compared with the control group. They promoted cognitive  flexibility, working memory, verbal fluency, and learning on cognitively intact or impaired older  adults. Moderate exercise intensity (60-120 min per week) only was needed to significantly  increased cognition scores.  

Effects of Mind-Body Exercises on Cognitive Function in Older Adults: A Meta Analysis.

Wu C, Yi Q, Zheng X, Cui S, Chen B, Lu L, Tang C.
J Am Geriatr Soc. 2019  Apr;67(4):749-758. doi: 10.1111/jgs.15714. Epub 2018 Dec 18.PMID: 30565212  


Study 3
Yu, et al, reviewed 16 randomized controlled trials with 1054 participants. They found that  compared with conventional therapy alone, baduanjin plus conventional therapy significantly  improved cognitive and memory function in patients with mild cognitive impairment.  

Systematic review and meta-analysis of randomized controlled trials assessing the  impact of Baduanjin exercise on cognition and memory in patients with mild cognitive  impairment.
Yu L, Liu F, Nie P, Shen C, Chen J, Yao L.
Clin Rehabil. 2021  Apr;35(4):492-505. doi: 10.1177/0269215520969661. Epub 2020 Nov 4.PMID:  33143442  


Study 4
Wei, et al, reviewed 12 studies. They found that tai chi exercise had a large beneficial effect on  global cognitive ability and long-term delayed recall ability from the memory domain. In terms of  executive ability, tai chi intervention had a moderate and significant effect on improving  patients' executive function. They concluded that the results suggest a tai chi intervention  lasting at least 12 weeks with a frequency of three times per week and 30–60 min per session.  

The impact of Tai Chi on cognitive rehabilitation of elder adults with mild cognitive  impairment: a systematic review and meta-analysis.
Wei L, Chai Q, Chen J, Wang Q,  Bao Y, Xu W, Ma E.
Disabil Rehabil. 2020 Oct 12:1-10. doi:  10.1080/09638288.2020.1830311. Online ahead of print.PMID: 33043709  


Study 5
Chen, et al, reviewed 16 studies with 1121 participants. The findings suggest that tai chi has  beneficial effects on cognitive function, but a longer duration was not associated with larger effects.  

Dose-Response Association of Tai Chi and Cognition among Community-Dwelling  Older Adults: A Systematic Review and Meta-Analysis.
Chen ML, Wotiz SB, Banks  SM, Connors SA, Shi Y.
Int J Environ Res Public Health. 2021 Mar 19;18(6):3179. doi:  10.3390/ijerph18063179.PMID: 33808633  


Study 6
In Lin, et al, seven random control trials with 1265 participants were reviewed. Tai chi  significantly improved mild cognitive impairment patients' cognitive function, including overall  cognitive function, memory and learning, visuospatial ability, executive functions, and physical  activity. However, no benefit was found for psychological activity or biomarkers.  

Effects of Tai Chi on Patients with Mild Cognitive Impairment: A Systematic Review  and Meta-analysis of Randomized Controlled Trials.
Lin R, Cui S, Yang J, Yang H,  Feng Z, Wahner-Roedler DL, Zhou X, Salinas M, Mallory MJ, Do A, Bublitz SE, Chon  TY, Tang C, Bauer BA, Xu M.
Biomed Res Int. 2021 Apr 12;2021:5530149. doi:  10.1155/2021/5530149. eCollection 2021.PMID: 33977103  


Study 7
Liu, et al, reviewed 33 random control trials, with 1808 participants. They concluded that tai chi  could improve global cognition when assessed in middle-aged as well as elderly patients  suffering from cognitive and executive function impairment.  

Can Tai Chi Improve Cognitive Function? A Systematic Review and Meta-Analysis of  Randomized Controlled Trials.
Liu F, Chen X, Nie P, Lin S, Guo J, Chen J, Yu L.
J  Altern Complement Med. 2021 Dec;27(12):1070-1083. doi: 10.1089/acm.2021.0084.  Epub 2021 Jul 26.PMID: 34314596  


Study 8
Lim, et al, also reviewed nine studies and found that they had an impact on global cognitive  functions, visuospatial skills, semantic memory, verbal learning/memory, and self-perception of  memory. The effects of tai chi on overall cognition for people with mild cognitive impairment are  about the same as people who engaged in exercise.

The effectiveness of Tai Chi for short-term cognitive function improvement in the  early stages of dementia in the elderly: a systematic literature review.
Lim KH,  Pysklywec A, Plante M, Demers L.
Clin Interv Aging. 2019 May 8;14:827-839. doi:  10.2147/CIA.S202055. eCollection 2019.PMID: 31190769


Study 9
Su, et al, reviewed 23 studies on 2282 participants. They found that traditional Chinese  medicine exercises were superior to conventional therapies (usual care, stretching, toning,  health education or routine daily exercises) using a pair-wise meta-analysis. They concluded  that traditional Chinese medicine exercise therapies may improve the cognitive function in  elderly patients with mild cognitive Impairment. They also ranked the different types of  traditional Chinese medicine exercises and found baduanjin qigong as the best, tai chi next,  followed by a qigong finger exercise.  

The Comparative Effectiveness of Traditional Chinese Medicine Exercise Therapies in  Elderly People With Mild Cognitive Impairment: A Systematic Review and Network  Meta-Analysis.
Su K, Yuan J, Liu H, Luo M, Li Q, Liu S, Feng X.
Front Neurol. 2022  Mar 16;13:775190. doi: 10.3389/fneur.2022.775190. eCollection 2022.PMID:  35370918  


Study 10
Wang, et al, reviewed nine studies, and did a meta-analysis on five of them with 338  participants. The meta-analysis showed that tai chi had a mild effect on global cognitive  function. The authors concluded mind-body therapies may be non-pharmaceutical approaches  to improve health outcomes among older people with dementia.  

Mind-body therapies for older adults with dementia: a systematic review and meta analysis.
Wang Y, Tang C, Fan X, Shirai K, Dong JY.
Eur Geriatr Med. 2022 Apr 4. doi:  10.1007/s41999-022-00639-z. Online ahead of print.PMID: 35377128 Review.  


Study 11
Zhou, et al, provides clinicians with moderate evidence to recommend that traditional Chinese  exercises hold potential to enhance both global cognitive function and multiple domains of  cognitive function. They reviewed nine trials with 1,290 participants. The effect on global  cognitive function was larger for the inactive control than the active control. Statistically  significant effects were also found for short-term memory, long-term memory, shifting, language  ability, and visuospatial perception.  

Effects of Traditional Chinese Exercises on Cognitive Function in Older Adults With  Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.
Zhou K, Liu M,  Bao D, Zhou J.
Front Hum Neurosci. 2022 Mar 25;16:849530. doi:  10.3389/fnhum.2022.849530. eCollection 2022.PMID: 35399354  


Study 12
Two more systematic reviews suggest tai chi has impacts on global cognitive functions,  visuospatial skills, semantic memory, verbal learning/memory, and self-perception of memory.  The effects of tai chi on overall cognition for people with mild cognitive impairment are  comparable to those in control groups which engaged in exercise. Yang, et al reviewed eleven  studies with 1061 participants. Gu, et al, reviewed nine studies with 827 participants. They  noted some positive evidence, and concluded that tai chi is a safe exercise that can bring better  changes in cognitive function score.

Tai Chi is Effective in Delaying Cognitive Decline in Older Adults with Mild Cognitive  Impairment: Evidence from a Systematic Review and Meta-Analysis.
Yang J, Zhang L,  Tang Q, Wang F, Li Y, Peng H, Wang S.
Evid Based Complement Alternat Med. 2020  Mar 25;2020:3620534. doi: 10.1155/2020/3620534. eCollection 2020.PMID:  32308706  

Effect of Tai Chi on Cognitive Function among Older Adults with Cognitive Impairment:  A Systematic Review and Meta-Analysis.
Gu R, Gao Y, Zhang C, Liu X, Sun Z.
Evid Based Complement Alternat Med. 2021 Aug 5;2021:6679153. doi:  10.1155/2021/6679153. eCollection 2021.PMID: 34394392  


Study 13
Six meta-studies examined the effectiveness of tai chi and qigong on depression, anxiety, or  negative emotions. Four of the studies found positive results, and two found weak positive results.  Guo, et al, reviewed seven randomized controlled trials published between 2004 and 2017  totaling 382 participants. The authors concluded that qigong-based exercises may be effective  for alleviating depression symptoms in individuals with major depressive disorder.  

Qigong-Based Therapy for Treating Adults with Major Depressive Disorder: A Meta Analysis of Randomized Controlled Trials.
Guo L, Kong Z, Zhang Y.
Int J Environ Res  Public Health. 2019 Mar 7;16(5):826. doi: 10.3390/ijerph16050826.PMID: 30866431  


Study 14
Ye, et al concluded that traditional Chinese therapy such as tai chi, qigong, and acupuncture  could possibly improve physiological markers of depression such as brain metabolites, brain  activity, and immune and endocrine systems of depressed individuals. Ye, et al reviewed twelve  articles and included eight in the meta-analysis. The sample sizes ranged from 36 to 125 and  only three studies included tai chi and qigong – the rest were on acupuncture. All three studies  of tai chi and qigong reported a significant improvement in depressive syndromes after tai chi  and qigong intervention.  

The Neuroscience of Nonpharmacological Traditional Chinese Therapy (NTCT) for  Major Depressive Disorder: A Systematic Review and Meta-Analysis.
Ye J, Cheung  WM, Tsang HWH.
Evid Based Complement Alternat Med. 2019 May  15;2019:2183403. doi: 10.1155/2019/2183403. eCollection 2019.PMID: 31223326  


Study 15
Zhang, et al, reviewed fourteen studies with 1285 participants which showed that the practice of  tai chi produced significant improvement in negative emotions in young adults and old adults.  The older adults benefited more than the younger adults. So, et al, reviewed nine studies with  sample sizes from 24 to 116 and found that qigong was effective at reducing depression  symptoms via activation of the parasympathetic nervous system.  

The Effect of Tai Chi Chuan on Negative Emotions in Non-Clinical Populations: A  Meta-Analysis and Systematic Review.
Zhang S, Zou L, Chen LZ, Yao Y, Loprinzi PD,  Siu PM, Wei GX.
Int J Environ Res Public Health. 2019 Aug 21;16(17):3033. doi:  10.3390/ijerph16173033.PMID: 31438638  

The Neurophysiological and Psychological Mechanisms of Qigong as a Treatment for  Depression: A Systematic Review and Meta-Analysis.
So WWY, Cai S, Yau SY,  Tsang HWH.
Front Psychiatry. 2019 Nov 18;10:820. doi: 10.3389/fpsyt.2019.00820.  eCollection 2019.PMID: 31824346  


Study 16
Liu, et al, reviewed four random control trials and six non-randomized comparison studies were  identified, including 1,244 adolescents. The results suggested a potential beneficial effect of tai  chi and qigong exercise on reducing anxiety and depression symptoms, and reducing cortisol  level (stress hormone) in adolescents. Conversely, non-significant effects were found for stress,  mood, and self-esteem. The findings of this review suggest qigong appears to be an effective  therapeutic modality to improve psychological well-being in adolescents.  

The Effects of Tai Chi and Qigong Exercise on Psychological Status in Adolescents: A  Systematic Review and Meta-Analysis.
Liu X, Li R, Cui J, Liu F, Smith L, Chen X,  Zhang D.
Front Psychol. 2021 Nov 24;12:746975. doi: 10.3389/fpsyg.2021.746975.  eCollection 2021.PMID: 34899487  


Study 17
Cai, et al, reviewed 25 randomized control trials with 1,819 participants and found that tai chi  has a positive effect on anxiety and depression, especially for patients with cancer, stroke, and heart failure. However the authors notes that tai chi is not a substitute for psychiatric treatment.

Tai Chi for anxiety and depression symptoms in cancer, stroke, heart failure, and  chronic obstructive pulmonary disease: A systematic review and meta-analysis.
Cai Q,  Cai SB, Chen JK, Bai XH, Jing CX, Zhang X, Li JQ.
Complement Ther Clin Pract. 2022  Feb;46:101510. doi: 10.1016/j.ctcp.2021.101510. Epub 2021 Nov 2.PMID: 34749040