Senin, 21 Maret 2011

Tai Chi Eases Depression in Elderly


Tai chi.
Robert Spencer for The New York TimesA tai chi group practicing in Pawtucket, R.I.
The ancient Chinese practice of tai chi appears to relieve symptoms of depression in older people, a new study shows.

The findings, published this month in The American Journal of Geriatric Psychiatry, are the latest to suggest that the slow movement, breathing and meditation of tai chi results in meaningful benefits to patients with chronic health problems. Other recent studies have shown that practicing tai chi may provide benefits for patients with arthritis and fibromyalgia. But the newest research is important because depression is notoriously difficult to treat in older people, many of whom are already coping with other health problems and are less likely to respond to drug treatment.

Researchers from the University of California, Los Angeles, studied 112 older adults in whom major depression had been diagnosed, including many who had been struggling with the illness for years. Their average age was about 70. Everyone was first treated with Lexapro, and 73 exhibited a partial improvement but still scored high on depression scales. The rest of the patients dropped out of the study, including just one patient who had a full remission after drug treatment.

The remaining depressed patients were randomly assigned to either a 10-week course of tai chi or a health education class, which included 10 minutes of simple stretching exercises. Both courses were given for two hours once a week.

After 10 weeks of tai chi, 94 percent of depressed older adults showed marked improvement on depression scales, compared with 77 percent in the health education group. And 65 percent of the people in the tai chi group experienced remission, compared with 51 percent in the education group.

The tai chi group also showed marked improvement in measures of physical function, cognitive tests and blood tests measuring levels of inflammation.

“Altogether the effects were pretty dramatic,’’ said Dr. Helen Lavretsky, lead author and professor of psychiatry at U.C.L.A. “If a psychiatrist were to add exercise like tai chi, which is very nondemanding and easy to access, that would be a very beneficial thing instead of adding another drug.”

Dr. Lavretsky said one reason both study groups showed improvement was that all the patients probably benefited from spending time with other people, whether it was in the practice of tai chi or the group education class. “I’m sure the social aspect contributed to the improvement in both groups,’’ she said. “In the control group we see improvement, and that was purely because of the social interaction and bonding that occurred.”

But the marked improvement in the tai chi group suggests an additional benefit from tai chi. Research has shown tai chi can improve physical function and quality of life, relieve stress and anxiety and lead to improved sleep quality, the study authors noted.

The study used a form of tai chi called T’ai Chi Chih that uses 20 simple exercises that are nonstrenuous and easy enough to be performed by older adults.

Dr. Lavretsky said the findings are exciting because depression is so difficult to treat in older people, two-thirds of whom don’t respond to initial drug therapy. Often when a patient doesn’t respond to the first drug, an additional drug is given, but that’s not always practical for patients who are already taking 10 or 15 drugs for other health problems. A study this month found that more than 60 percent of patients over 65 experience moderate or major side effects the first time they are prescribed an antidepressant.

“This is very easily translatable into community care,’’ she said. “As their health improves, they may be able to reduce the other drugs they are taking for pain or other problems.”

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