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Background real-world observations on the long-term benefits of Tai Chi (TC) exercise, in terms of physical and cognitive functioning, frailty, quality of life (QOL) and mortality are lacking. Methods prospective cohort study participants were community-dwelling adults aged 55+, including 5,407 non-frequent TC participants (<1x/week) and 572 frequent TC participants (≥1x/week). Outcome measures at baseline and 3–5 years follow-up included physical performance (Knee Extension Strength, POMA Balance and Gait, Timed-up-and-go, Gait Speed) and neurocognitive performance (attention and working memory, visual-motor tracking and mental flexibility, verbal learning and memory, visual memory, spatial and constructional ability), Frailty Index ≥0.10, impaired QOL (SF12 physical and mental component) and all-cause mortality from mean 13 years follow-up. Effect estimates were adjusted for socio-demographics, other physical activities, nutritional risk and presence of cardiometabolic diseases. Results frequent TC participation was associated with 0.7-fold lower prevalence of impaired physical QOL [95% confidence interval (CI) = 0.57–0.91], decreased 0.4-fold odds of incident prefrailty/frailty among robust participants at baseline and 0.7-fold odds of impaired mental QOL at follow-up among participants with normal mental QOL at baseline. Lower odds of mortality risk (HR = 0.89, 95%CI = 0.72–1.09) were not significant after controlling for socioeconomic, behavioural and health factors. Composite indexes of physical functional and neurocognitive performance were maintained at high level or increased at follow-up among frequent TC participants. Conclusion TC exercise practised among community-dwelling older adults is associated with better physical, cognitive and functional wellbeing. [ABSTRACT FROM AUTHOR]

Background Motor and gait disturbances are evident in early Alzheimer and non-Alzheimer dementias and may predict the likelihood of mild cognitive impairment (MCI) or progression to dementia. Objective We investigated the Timed-Up-and-Go (TUG) measure of functional mobility in predicting cognitive decline and incident MCI or early dementia (MCI–dementia). Design Prospective cohort study with 4.5 years follow-up. Setting Population based. Participants 2,544 community-dwelling older adults aged 55+ years. Methods Participants with baseline data on TUG, fast gait speed (GS), knee extension strength (KES) and performance-oriented mobility assessment (POMA) gait and balance were followed up for cognitive decline (Mini-Mental State Exam; MMSE drop of ≥2, among 1,336 dementia-free participants) and incident MCI–dementia (among 1,208 cognitively normal participants). Odds ratio (OR) and 95% confidence intervals (95% CI) were adjusted for age, sex, education, smoking, physical, social and productive activity, multi-morbidity, metabolic syndrome and MMSE. Results Per standard deviation increase in TUG, POMA, GS and KES were significantly associated with incident MCI–dementia: TUG (OR = 2.84, 95% CI = 2.02–3.99), GS (OR = 2.17, 95% CI = 1.62–2.91), POMA (OR = 1.88, 95% CI = 1.22–2.92) and KES (OR = 1.52, 95% CI = 1.15–2.02). Adjusted OR remained significant only for TUG (OR = 1.52, 95% CI = 1.01–2.31) and GS (OR = 1.53, 95% CI = 1.08–2.16). Areas under the curve (AUC) for TUG (AUC = 0.729, 95% CI = 0.671–0.787) were significantly greater than GS (AUC = 0.683, 95% CI = 0.619–0.746), KES (AUC = 0.624, 95% CI = 0.558–0.689) and POMA (AUC = 0.561, 95% CI = 0.485–0.637). Similar associations with cognitive decline were significant though less pronounced, and adjusted ORs remained significant for TUG, GS and POMA. Conclusion Functional mobility decline precedes incident MCI and early dementia. The TUG appears to be especially accurate in predicting the future risks of adverse cognitive outcomes. Trial Registration ClinicalTrials.gov NCT03405675. Registered 23 January 2018 (retrospectively registered). [ABSTRACT FROM AUTHOR]