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

Abstract

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:

• Tai Chi
• hypertension
• psychological well-being
• resilience
• COVID-19

Disclosure statement

The Authors have declared that there are no conflicts of interest in relation to the subject of this study.

Additional information

Funding

This work was supported, in part, by the National Heart, Lung, and Blood Institute (R01HL126056 to SH and LSR), the National Institute on Aging (R03AG063328 to SH), the National Institute of Mental Health (T32MH019934 to JNK, T32MH018399 to EAT), and the National Institute on Drug Abuse (T32DA031098 to JDL). The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Clinicaltrials.gov Identifier: NCT02761603.