Tai Chi versus health education as a frailty intervention for community-dwelling older adults with hypertension

• Published in: Aging clinical and experimental research Vol. 35; no. 10; pp. 2051 - 2060
• Main Authors: Kohn, Jordan N., Lobo, Judith D., Troyer, Emily A., Ang, Gavrila, Wilson, Kathleen L., Walker, Amanda L., Spoon, Chad, Pruitt, Christopher, Tibiriçá, Lize, Pung, Meredith A., Redwine, Laura S., Hong, Suzi
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-10-2023; Springer Nature B.V
• Subjects: Aged; Female; Frail Elderly; Frailty; Frailty - complications; Frailty - therapy; Geriatric Assessment; Geriatrics/Gerontology; Health Education; Humans; Hypertension; Hypertension - complications; Hypertension - therapy; Independent Living; Male; Martial arts; Medicine; Medicine & Public Health; Older people; Original Article; Tai Ji; Hypertension; Tai Chi; Frailty; Randomized controlled trial
• ISSN: 1720-8319; 1594-0667; 1720-8319
• DOI: 10.1007/s40520-023-02504-w

Background
Frailty is associated with poor outcomes among older adults with hypertension and complicates its pharmacological management. Here, we assessed whether 12-weeks of instructor-guided, group Tai Chi (TC) practice improved frailty relative to Healthy Aging Practice-centered Education (HAP-E) classes in older adults with hypertension.
Methods
Secondary analysis of a randomized controlled trial in San Diego County, USA, of 167 community-dwelling individuals aged ≥ 60 yrs (70% female; 72.1 ± 7.5 yrs), defined as non-frail (66%) or frail (34%) based on 53-item deficit accumulation frailty index (FI). Linear mixed-effects models were used to assess pre-to-post intervention differences in FI and logistic regression to explore differential odds of clinically meaningful FI change.
Results
One hundred thirty-one participants completed post-intervention assessments. Frailty decreased pre-to-post intervention in the TC (ΔFI = − 0.016,
d
 = − 0.39, − 0.75 to − 0.03), but not the HAP-E arm (ΔFI = − 0.009,
d
 = − 0.13, − 0.52–0.27), despite no significant group differences between the TC and HAP-E arms (
d
 = − 0.11, − 0.46–0.23). Furthermore, greater odds of improved FI were observed for frail participants in the TC (OR = 3.84, 1.14–14.9), but not the HAP-E (OR = 1.34, 0.39–4.56) arm. Subgroup analysis indicated treatment effects in TC were attributed to frail participants (frail: ΔFI = − 0.035,
d
 = − 0.68, -1.26 to − 0.08; non-frail: ΔFI = − 0.005,
d
 = − 0.19, − 0.59–0.22), which was not the case in the HAP-E arm (frail: ΔFI = − 0.017,
d
 = − 0.23, − 0.81–0.35; non-frail: ΔFI = − 0.003,
d
 = − 0.07, − 0.47–0.33). Frail participants were no more likely to drop-out of the study than non-frail (71% vs. 69% retained).
Conclusions
Twelve weeks of twice-weekly guided TC practice was well-tolerated, associated with decreases in frailty, and increased odds of clinically meaningful FI improvement at post-intervention.