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swimming, tai chi consists of a series of forms — specific positions of the body. "While practicing tai chi, the individuals need to transition from form to form smoothly," Siu says. "Notably, each form has specific requirements in meditation, posture and movements. The individual needs to adopt a new set of requirements while transitioning from one form to another, and therefore may train up the capability of selectively switching between mental processes to achieve appropriate behav iora l responses, a nd ef f icient adaptation to the change in requirements or demands (i.e. cognitive flexibility)." La stly, ta i chi is thought to create b e n e f i c i a l c h a n g e s i n t h e b r a i n , which other studies seem to confirm. Specifically, a 2018 study by Angus P. Yu et al reports a brain adaption from tai chi in regions of the brain responsible for gait, balance, mood and cognitive function. Additionally, a 2021 pilot study led by Lei Cui indicates functiona l changes in the brain that associate tai chi with improvement in cognitive flexibility. However, further research is needed to fully understand how tai chi improves globa l cognitive function and creates beneficial changes in the brain. IN CLINICAL PRACTICE Si nc e t here i s no c u r rent c u re for dementia, hea lthcare providers often recommend strategies that may prevent or delay cognitive decline. Regular exercise is one of those strategies. However, for older adults, fear of injury or concern about starting an exercise program that is perceived as too difficult may be a hindrance in getting enough regular physical activity. Tai chi could provide a safe alternative for older patients who need activity recommendations. "It is noteworthy that the slow and low- impact movements of tai chi make it a safe exercise for older adults who are physically unfit or with chronic conditions," Siu says. "Tai chi can be a good option for older adults to engage in regular exercise for preventing cognitive decline. Primary care providers may consider recommending tai chi to patients as one of the approaches to prevent cognitive decline." However, Siu emphasizes that providers should recommend numerous approaches to cognitive health — not one exercise modality alone. According to Siu, the frequency and duration of physical activity sufficient to prevent cognitive decline — whether tai chi or other conventional exercise — remains unclear. Further research is required t o det er m i ne a n ef fec t ive exerci se recommendation to protect patients against cognitive impairment. n Tai Chi Without Meditation Is Not Tai Chi A LITER ATURE RE V IE W in the geriatric medicine section of Frontiers in Medicine found that "[d]ual-task training, which includes cognitive demands in addition to physical or motor activity, has proven to be more effective in improving cognitive functioning than a single task." Tai chi, a mind-body exercise which emphasizes both elements of meditation and physicality, is an example of dual-task training. Tai chi with only body movement and without meditation is not a complete practice, which indicates that someone who practices tai chi in body only is unlikely to benefit from the full health and brain improvements that tai chi is supposed to deliver. "Most of the individuals who first engaged in tai chi usually put too much attention on the gesture and physical movements but omit the meditation element, which is equally influential as the physical element," says Parco Siu, BSc, MPhil, PhD, FRSB, FACSM, FECSS, FHK ASMSS, Associate Professor and Division Head of the Department of Kinesiology at the University of Hong Kong. "Therefore, when an individual wants to practice tai chi to improve their health, they should [pay] similar attention to both of the meditation and physical elements to obtain the greatest health benefits of tai chi." M D N E W S . C O M /// M D N E W S C E N T R A l P E N N S y lVA N i A ■ 2 0 2 3 1 5