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

CATEGORY: STRESS & MIND-BODY

Older adults with mild memory problems who spent six months practicing a form of tai chi with mental challenges woven into the movements scored 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—in a randomized trial published in the Annals of Internal Medicine.¹ The gains were still measurable six months after the classes ended.

A Slow Dance With Spelling Drills Inside

Tai chi is a gentle exercise in which a series of postures flows one into the next, performed slowly and deliberately while breathing deeply—closer to a slow dance than a workout. The version tested in this trial, called cognitively enhanced tai ji quan, keeps those same flowing movements but builds mental work directly into them: while moving through the forms, participants handled tasks such as spelling words forward and backward. The idea under study was that exercising the body and challenging the mind at the same moment might do more for a strained memory than either alone.

Three Classes by Video, One Hour Twice a Week

Researchers at the Oregon Research Institute enrolled 318 adults aged 65 and older who reported memory decline or concerns, most with mild cognitive impairment—a stage of memory and thinking trouble that is noticeable on testing but not severe enough to be dementia. Each person was randomly assigned to one of three classes: the enhanced tai ji quan, standard tai ji quan, or a stretching-and-relaxation program. All three groups exercised the same amount—a one-hour class twice a week for 24 weeks—and did so 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, before the classes began, partway through, at the end, and again six months after the classes stopped; 96% of participants completed the main 24-week assessment.¹

Nearly Three Points on a 30-Point Test, Still There Six Months Later

The trial was designed to test whether the mentally loaded version would outperform the other two, and 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 The enhanced group also improved more on a task that captures a very practical skill: walking while doing something mental at the same time. Researchers measured how much each person’s walking slowed when they had to think and walk at once—the everyday equivalent of keeping a grocery list in mind while crossing a busy parking lot—and the enhanced group’s slowdown shrank substantially more than either comparison group’s. When everyone was retested six months after the classes ended, the differences had held.

Nine Smaller Trials Point the Same Way

This result does not stand alone. A 2025 review that pooled nine randomized trials of tai chi in 1,066 older adults with mild cognitive impairment found that the practice improved overall thinking scores, with one qualification worth knowing: the benefit showed up clearly in longer-running programs, while short-term programs did not produce a statistically clear gain.² That pattern fits the trial described here, where the classes ran a full six months.

What a Stretching Comparison Can and Cannot Prove

The trial’s design earns its verbs—people were randomly assigned, so the differences can be credited to the classes themselves rather than to who chose them. Two limits still matter. There was no group that did nothing, so the study cannot say how much 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, not dementia, so the findings describe people in that earlier window. The size of the gain also deserves plain framing: about 3 points on a 30-point test is a real, measurable difference, not a transformation. What makes the result notable is the combination—a low-cost home program, delivered entirely by video, that moved the needle on cognition in a group at elevated risk of decline and kept it moved for six months after the program ended.

Key Takeaways

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

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