Adding Mental Drills to Tai Chi Boosted Thinking Scores in Older Adults With Memory Concerns

CATEGORY: STRESS & MIND-BODY

Does loading a mental task onto exercise buy anything the exercise alone would not? Older adults with mild memory problems spent six months practicing a form of tai chi with mental challenges woven into the movements. They finished nearly 3 points higher on a 30-point thinking test than peers assigned to stretching classes, and about 1.5 points higher than those doing standard tai chi.¹ Six months after the classes ended, the gains were still measurable.

Spelling Words Backward While Moving Through the Forms

Tai chi is a gentle exercise in which a series of postures flows one into the next, performed slowly and deliberately with deep breathing. It is closer to a slow dance than a workout. The version tested here, cognitively enhanced tai ji quan, keeps those flowing movements and builds mental work directly into them. While moving through the forms, participants handled tasks such as spelling words forward and backward. The premise under test was that working the body and taxing the mind in the same moment might do more for a strained memory than either does by itself.

Three Classes by Video, Two Hours a Week for 24 Weeks

Researchers at the Oregon Research Institute enrolled 318 adults aged 65 and older who reported memory decline or concerns. Most had mild cognitive impairment, a stage of memory and thinking trouble noticeable on testing but not severe enough to count as dementia. A random draw placed each person in one of three classes: enhanced tai ji quan, standard tai ji quan, or a stretching-and-relaxation program. Chance, not preference, made that choice, which is what lets the differences be laid at the door of the classes themselves. All three groups exercised the same amount, an hour twice a week for 24 weeks, at home over live videoconference. Thinking ability was measured with the Montreal Cognitive Assessment, a standard 30-point screening test of memory, attention and reasoning. It was given before the classes began, partway through, at the end, and again six months after the classes stopped. Of the participants, 96% completed the main 24-week assessment, and the trial was published in the Annals of Internal Medicine.¹

Nearly Three Points, Still There Half a Year Later

The trial was designed to test whether the mentally loaded version would outperform the other two. It did. After 24 weeks the enhanced group had improved by 2.8 points more than the stretching group on the 30-point test, and by 1.5 points more than the standard tai chi group.¹ It also pulled ahead on a task that captures something practical: walking while thinking about something else. Researchers measured how much each person’s walking slowed when a mental task was added, the everyday equivalent of holding a grocery list in mind while crossing a busy parking lot. The enhanced group’s slowdown shrank substantially more than either comparison group’s. Everyone was retested six months after the last class, and the differences had held.

What a Stretching Comparison Cannot Settle

Two limits matter. No group did nothing at all, so the study cannot say how far any of the three programs beats ordinary life; it can only rank them against each other. And participants had mild or self-reported memory trouble rather than dementia, so the finding describes people in that earlier window. The size of the gain deserves plain framing too. About 3 points on a 30-point test is a real, measurable difference, not a transformation. Nine other trials land in the same territory: a 2025 review pooling them, covering 1,066 older adults with mild cognitive impairment, found tai chi improved overall thinking scores, with the benefit clear in longer-running programs and not statistically clear in short ones.² The classes in this trial ran a full six months.

Key Takeaways

• Tai chi with mental tasks built in, such as spelling words backward while moving, improved 30-point thinking scores by 2.8 points more than stretching and 1.5 points more than standard tai chi over six months in 318 adults aged 65 and older with mild memory concerns.
• The gains, including steadier walking while multitasking, were still present six months after the classes ended.
• There was no do-nothing comparison group, so the trial ranks the three programs against each other rather than against no exercise.
• A pooled analysis of nine other randomized trials points the same way, with clearer benefits from longer programs than brief ones.

References

1. Li F, Harmer P, Eckstrom E, Fitzgerald K, Winters-Stone K. Clinical Effectiveness of Cognitively Enhanced Tai Ji Quan Training on Global Cognition and Dual-Task Performance During Walking in Older Adults With Mild Cognitive Impairment or Self-Reported Memory Concerns: A Randomized Controlled Trial. Annals of Internal Medicine. 2023;176(11):1498–1507. link
2. Wang WT, Wang H. Effects of Tai Chi Chuan on cognitive function in adults 60 years or older with mild cognitive impairment: a systematic review and meta-analysis. Frontiers in Physiology. 2025;16:1556622. link