Frontiers in Psychology · Oct 30, 2026
The relationship between Tai Chi exercise and psychological distress in older adults: the chain mediation effect of mood state and sleep quality
By Pengfei Xu, Leiming Yang
BackgroundPsychological distress is a common mental health issue among older adults, significantly affecting their quality of life and overall health. As a traditional form of mind–body exercise, Tai Chi is gaining increasing attention for its mental health benefits. However, the effects of Tai Chi practice on psychological distress in older adults remain unclear, and the mechanisms underlying its impact on mood and sleep quality, in particular, still need to be explored.ObjectivesThis study aims to explore the relationship between Tai Chi exercise and psychological distress in older adults, and to examine the chained mediating effects of mood state and sleep quality in this association.MethodologyQuestionnaires containing the Physical Activity Rating Scale (PARS-3), the Positive and Negative Mood States (POMS) scale, the Pittsburgh Sleep Quality Index (PSQ), and the final versions of non-specific psychological distress scales (Kessler 10), a total of 457 valid questionnaires were collected.ResultsAnalysis of the mediation effects in this study were statistically consistent with a mediating role of the relationship between Tai Chi exercise and psychological distress in older adults. The effect size of the total indirect effect was −0.265 (95% CI [−0.339, −0.197], p < 0.01), accounting for 53.9% of the total effect. The mediation effect consisted of three pathways. Path 1: Tai Chi exercise → Mood state → Psychological distress in older adults, with an effect size of −0.159 (95% CI [−0.221, −0.103], p < 0.01). Path 2: Tai Chi exercise → Sleep quality → Psychological distress in older adults, with an effect size of −0.067 (95% CI [−0.112, −0.032], p < 0.01). Path 3: Tai Chi exercise → Mood state → Sleep quality → Psychological distress in older adults, with an effect size of −0.039 (95% CI [−0.065, −0.020], p < 0.01).ConclusionThis study identified a significant association between Tai Chi exercise and the alleviation of psychological distress in older adults, and this association may be explained by the chained mediating effects of mood state and sleep quality.