Cognitive decline in older adults is a major public health problem and can compromise independence and quality of life. Exercise and diet have been studied independently and have shown to be beneficial for cognitive function, however, a combined Tai Chi, resistance training, and diet intervention and its influence on cognitive function has not been undertaken. The current study used a 12-week non-randomized research design with experiment and control groups to examine the effect of a combined Tai Chi, resistance training, and diet intervention on cognitive function in 25 older obese women. Results revealed improvements in domain specific cognitive function in our sample. Baseline cognitive function was correlated with changes in dietary quality. These findings suggest that Tai Chi and resistance training combined with diet intervention might be beneficial for community-based programs aiming to improve cognitive function.

BACKGROUND: Cognitive decline in older adults is a public health problem and prior research shows that higher levels of physical activity and dietary factors are associated with higher cognitive function. However, it is unclear how an exercise and diet intervention affects cognitive function in obese older women. PURPOSE: To examine the effect of a combined Tai Chi (TC), resistance training (RT), and diet intervention on cognitive function and to evaluate the relationship between cognitive function and physical function in older obese women. METHODS: This was a non-randomized study where 31 obese (BMI= 37.6 ± 4.5 kg/m2) older (age= 65.1 ± 8.4 years) women (61% African-American) were recruited to a 12-week intervention (EXD) group or to a control (CON) group. Cognitive function was measured via the Repeatable Battery for the Assessment of Neurological Status (RBANS) test. Other outcomes were grip strength, 4 m walk, leg strength, chair stands, and timed up and go. Baseline measures were assessed under standardized conditions prior to the start and at the end of the study by trained staff supervised by a licensed speech-language pathologist. The EXD group (n=17; 5 dropouts) engaged in three 45 min TC sessions and two 45 min RT sessions per week. A registered dietitian conducted the behaviorally based diet sessions once a week. The CON group (n=8; 1 missing data) was asked to maintain a normal lifestyle. Pearson correlations were done for baseline physical function and RBANS score and analysis of covariance was used to compare RBANS score change between groups adjusted for baseline. RESULTS: RBANS score was positively correlated with grip strength (r = 0.51) and negatively correlated with timed up and go, (r = -0.40), chair stand (r = -0.28) and gait speed (r = -0.37) times (all p<0.05). Baseline RBANS score (87.5 ± 19.5) and baseline age were not correlated and RBANS scores were not different between groups (p= 0.80). There were no differences in RBANS score change in the EXD vs. CON groups (3.1 ± 2.0 vs. 2.5 ± 2.9; p=0.86). CONCLUSIONS: An exercise and diet intervention does not change cognitive function in older obese women, but baseline cognitive function is moderately correlated with physical function. A longer intervention needs to be tested in a larger sample to verify these results. Supported by the College of Environment and Life Sciences Community Access to Research and Extension Services (CELS CARES) grant, USDA, at the University of Rhode Island.

This study employed a quasi-experimental design in a community-based study translating the results of our recent findings on the combined effects of Tai Chi and weight loss on physical function and coronary heart disease (CHD) risk factors. A 16-week intervention was conducted to assess the impact of Tai Chi plus a behavioral weight loss program (TCWL, n = 29) on obese (body mass index [BMI] = 35.4 ± 0.8 kg/m2) older (68.2 ± 1.5 yr.) women compared to a control group (CON, n = 9, BMI = 38.0 ± 1.5 kg/m2, 65.6 ± 2.7 yr.), which was asked to maintain their normal lifestyle. The TCWL group lost weight (1.6 ± 2.9 kg, P = 0.006) while the CON group did not (1.2 ± 1.9 kg, P = 0.106). Physical functioning as measured by the short physical performance battery improved in TCWL when compared to the CON group (β = 1.94, 95% Confidence Interval [CI]: 1.12, 2.76, P < 0.001). TCWL also improved in sit-and-reach flexibility (β = −2.27, 95% CI: −4.09, −0.46, P = 0.016), body fat mass (BMI, β = −0.65, 95% CI: −1.03, −0.26, P = 0.002), waist circumference (β = −1.78, 95% CI: −2.83, −0.72, P = 0.002), systolic blood pressure (β = −16.41, 95% CI: −21.35, −11.48, P < 0.001), and diastolic blood pressure (β = −9.52, 95% CI: −12.65, −6.39, P < 0.001). Thus, TCWL intervention may represent an effective strategy to improve physical function and ameliorate CHD risk in the older adult population.

Up to 48% of older adults may be at increased nutrition risk. This is a concern as the number of older adults is projected to double by 2030 and obesity is suspected to rise to over 20% in the same population. The purpose of this analysis is to examine the impact of a diet and exercise intervention on diet quality in obese women in an urban setting. There were 26 women with mean age of 65.3 ± 8.1 years and BMI of 38.0 ±4.6 kg/m2 who completed a community based diet and exercise intervention. Seventeen women, 65% African‐American, were assigned to the intervention group (EXD) and participated in 12 weeks of Tai Chi (TC), resistance training (RT), and behavioral based diet intervention. Nine women were assigned to the control group (CON). The Dietary Screening Tool (DST) was used to assess diet quality; higher scores indicate better quality. Using an independent t‐test the EXD group had a significantly higher diet quality compared to the CON group (66.5 ± 10.2 vs. 53.5 ± 13.8; p=0.025) at post ‐intervention. Results from this analysis indicate that a behaviorally‐based diet, TC, and RT intervention may result in improved diet quality, however further research is needed.Grant Funding Source: College of Environment and Life Sciences Community Access to Research and Extension Services, USDA

Obesity is a major health problem in the USA, especially in minority populations over the age of 60 years, and the aging process can cause adverse effects on physical function. Previous research has shown that Tai Chi, resistance training (RT), and diet result in overall health improvements. However, the combination of these specific interventions has yet to be translated to obese older women in an urban setting. The purpose of this study was to examine a combined intervention on the primary outcomes of physical function and body composition. Using a nonrandomized design, 26 obese women (65.2±8.1years) completed a 12-week intervention; participants were assigned to an intervention (EXD) group or a control (CON) group. The EXD group (n=17) participated in Tai Chi, RT, and a dietary session. The CON group (n=9) was asked to continue their normal lifestyle. Timed up and go (TUG) time was reduced by0.64±2.1seconds (P=0.04) in the EXD group while the CON group saw a borderline significant increase of 0.71 sec (P=0.051). The combined intervention helped improve performance on TUG time, but there were no significant increases in other body composition or function measures.

Obese older women are at increased risk of chronic diseases that lifestyle modifications can attenuate. Combined nutrition and physical activity interventions can improve dietary quality and physical function and reduce chronic disease risk, but how cognitive function is associated with these outcomes is unknown. Twenty‐six obese older women (65.3±8.1 years and BMI 38.0 ± 4.6 kg/m2) completed a 12‐week quasi‐experimental community‐based intervention, with a behaviorally‐based modified Dietary Approaches to Stop Hypertension diet, Tai Chi (TC) and resistance training (RT). Seventeen women were in the diet, TC+RT intervention group (EXD) and 9 were in the waiting control group (CON). Cognitive score was assessed via the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Mean baseline RBANS score was 88.1 ± 19.9. The dietary screening tool (DST) was used to assess dietary quality, mean baseline score was 62.3 ± 11.1, which equates to at possible nutrition risk. The short physical performance battery (SPPB) was used to assess physical function; mean baseline score was 8.5±2.6. Baseline RBANS were positively associated with baseline (r=0.39, p=0.03) and post‐intervention SPPB scores (r=0.40, p=0.05) of all participants. Cognitive status is associated with physical function and future research should consider cognitive levels to create appropriate interventions in the community.Grant Funding Source: College of Environment and Life Sciences Community Access to Research and Extension Services (CELS C

Older obese women are at risk of obesity‐related disability, but Tai Chi has not been explored as an exercise modality along with weight loss for their effects on physical function. A 16‐week community‐based intervention was conducted to assess the impact of Tai Chi plus behaviorally‐based weight loss (TCWL, n=29) on obese (BMI=35.4 ±0.8 kg/m2) older (68.2±1.5 yr) women compared to a control group (CON, n=9, BMI=38.0±1.5kg/m2, 65.6±2.7 yr). The major outcome was the short physical performance battery (SPPB), consisting of 4‐m gait speed (GS), standing balance, and chair stand (CS) tests. The TCWL group participated in two Tai Chi sessions and one dietary weight loss session per week with a goal of 5–10% weight loss. The CON group was asked to maintain their normal lifestyle. The TCWL group lost weight, (1.6±2.9 kg, P=.006) while the CON group showed no significant change (1.2 ± 1.9 kg P=.11). SPPB score improved in TCWL (0.59±1.28, P=.023) when compared to the CON group (−0.56±1.81, P=.38). TCWL group improved GS (−0.14±0.76 sec, P=.34) time better (P=.004) than CON (0.56±0.81 sec, P=.07) and also improved CS (−0.80±1.71 sec, P=.02) time better (P=.065) than CON (0.28±2.83 sec, P=.77). Tai Chi may represent an effective intervention strategy to maintain and improve physical function while losing weight..

Tai Chi is an alternative exercise that has not been thoroughly investigated as an intervention strategy in this population when combined with dietary weight loss. A 16‐week non‐randomized intervention using Tai Chi and behaviorally‐based weight loss (TCWL, n=29) in older (68.2±1.5 yrs) obese (BMI=35.4±0.8kg/m2) women was conducted while using a control group (CON, n=9; BMI=38.0±1.5 kg/m2; age=65.5±2.7 yrs). Primary outcome measurements included total body mass, BMI, percent fat (via bioelectrical impedance analysis), body mass, hip and waist circumferences. Participants in the TCWL group engaged in twice weekly Tai Chi sessions (~45 min) and once weekly behaviorally‐based dietary weight loss meetings. The CON group was asked to continue with their daily routines during the intervention. The TCWL group lost 1.6±2.9 kg (P=0.006) and the CON group showed no change (−1.2±1.9 kg; P=0.11). BMI did not change in either the TCWL group (−0.7±1.0 kg/m2, P>;0.0017) or in the CON group (−0.5±1.0 kg/m2, P>;0.1896). There were no changes in fat mass or waist circumference in either group (both P>;0.05). The results from this preliminary study show that the combination of Tai Chi and dietary weight loss may not be effective in altering key measures of body composition in obese older women but further study is needed with more substantial weight loss.

Resilience is the ability to recover after a physical, emotional, financial, or social challenge. Limited research exists on the impact of dietary and physical activity interventions on resiliency. Fifty‐four obese, older women were recruited at two senior centers for a 16‐week community‐based intervention study that implemented a modified Dietary Approaches to Stop Hypertension (DASH) diet and Tai Chi (TC) exercise. At baseline, participants’ mean age was 68.2±7.7 years, with BMI of 35.4±4.3 kg/m2, and total cholesterol of 200.7±33.1 mg/dL. The mean Dietary Screening Tool (DST) score was 67.3±10.6 and the mean physical resiliency scale score was 12.96 ± 2.09. Significance was set at p<0.05. There was no significant difference at baseline between waitlist control (WC) and intervention (DASH‐TC) participants in any of the reported variables. One‐way repeated measures ANOVA comparing baseline to post‐intervention was significant for total DST score, BMI, waist circumference, systolic and diastolic blood pressure, and glucose; all with a large effect size. There was no significant interaction effect between WC and DASH‐TC groups in terms of physical resiliency; this may be related to a possible Hawthorne effect. The combination of DASH diet plus TC didn't seem to impact resiliency in this population. However, further research is needed to verify these results in larger, more diverse populations.