Summary: In a two-year follow-up of a randomised trial in older adults with type 2 diabetes and mild cognitive impairment, Tai Chi preserved global cognition and executive and visuospatial function better than health education and fitness walking, with nearly half achieving a clinically meaningful cognitive improvement.
PICO Summary
| Element | Detail |
|---|---|
| Population | 328 older adults (≥60 years) with type 2 diabetes and mild cognitive impairment; randomised 1:1:1 with 24-week intervention and assessments to 2 years, China. |
| Intervention | Tai Chi programme. |
| Comparison | Fitness walking or health education. |
| Outcome | At 2 years, there was a significant group-by-time interaction for MoCA (p<0.001). Tai Chi improved MoCA more than health education (mean difference 1.8; 95% CI 0.3–3.3; p=0.016). A clinically meaningful improvement (MoCA ≥4 points) was reached by 49.8% of Tai Chi practitioners, about double that of health education (HR 2.0) and exceeding fitness walking (HR 1.7). Tai Chi selectively improved executive function and visuospatial ability. |
Tai Chi and cognition in T2D with MCI
RCT · type 2 diabetes + MCI · 2 years
Over two years, Tai Chi practitioners were about twice as likely as health-education controls, and more likely than walkers, to reach a clinically meaningful cognitive gain, with durable benefits in executive and visuospatial function.
Expert Commentary
This is a notably strong study in a field where evidence is usually short-term and underpowered, and its two-year horizon with a three-arm design is its main strength, since comparing Tai Chi against active comparators, fitness walking and health education, rather than mere usual care, makes the cognitive signal harder to attribute to attention or social contact alone. The durability is the headline: cognition was preserved or improved over two years, with nearly half reaching a clinically meaningful MoCA gain, and the selective benefit for executive and visuospatial domains is functionally relevant because those govern planning, navigation, and independence. I would keep two caveats in view. The advantage over health education was clear, but the margin over fitness walking was more modest, so part of the benefit reflects exercise generally rather than Tai Chi specifically, and the trial was conducted in a single cultural setting where adherence to Tai Chi may differ from elsewhere. Can I use this with my patients? Yes, enthusiastically and realistically. For older diabetic patients with early cognitive concerns, I would actively recommend Tai Chi or, where unavailable, another structured mind-body or aerobic programme, as a safe, low-impact, accessible intervention, while keeping glycaemic and vascular risk management central to protecting the brain.
References
Li X, Huang J, Deng H, et al. 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. Aging Clin Exp Res. 2025;37(1):315. doi:10.1007/s40520-025-03218-x