Aging Clinical and Experimental Research · Nov 6, 2025

Two-year follow-up assessment of a randomized controlled trial evaluating the durability of Tai Chi on cognitive function in older adults with type 2 diabetes and mild cognitive impairment

By Li X, Huang J, Deng H et al.

AIMS: Building upon established short-term benefits, this study aimed to assess Tai Chi's durability for preserving global and domain-specific cognition in older adults (≥ 60 years) with type 2 diabetes and mild cognitive impairment (T2D-MCI), compared to fitness walking and health education. METHODS: Participants (n = 328) were randomized 1:1:1 to Tai Chi, fitness walking, or health education groups, completing 24-week interventions. Cognitive outcomes-global cognition (Montreal Cognitive Assessment, MoCA), executive function, attention, visuospatial ability, and language fluency-were evaluated at baseline, 24 weeks(post-intervention), 36 weeks, and 2 years. Linear mixed models analyzed group-by-time interactions, while time-dependent Cox regression quantified minimal clinically important difference (MCID) attainment (MoCA improvement ≥ 4 points). RESULTS: At 2-year follow-up, linear mixed models revealed significant group-by-time interactions for MoCA (p < 0.001). The Tai Chi group showed greater MoCA improvement versus health education (mean difference: 1.8, 95% CI 0.3-3.3, p = 0.016). Crucially, 49.8% of Tai Chi practitioners achieved MCID-nearly double the probability of health education (HR 2.0, 95% CI 1.4-2.8, p < 0.001) and exceeding fitness walking (HR 1.7, 95% CI 1.2-2.4; p = 0.005). Tai Chi selectively enhanced executive function (shorter Stroop reaction times vs. health education, p < 0.05; fewer color-word errors vs. fitness walking, p = 0.049) and visuospatial ability (higher Rey-Osterrieth copy scores vs. health education, p = 0.034). CONCLUSIONS: Tai Chi provides superior long-term preservation of global cognition and executive/visuospatial function in T2D-MCI older adults, with nearly 50% achieving clinically meaningful cognitive improvement. As a scalable mind-body intervention, it warrants integration into geriatric preventive care to mitigate dementia risk.

doi.org/10.1007/s40520-025-03218-xOpen accessPubMed 41196453Interventions