Developing an Online Tai Ji Program to Improve Health Outcomes in Older Adults

Project Summary/AbstractBackground. The ongoing COVID-19 public health crisis is significantly impacting older Americans who are athigher risk for severe illness from novel coronavirus infection. The implementation of shelter-in-place andsocial distancing, though an essential step in reducing transmission of the virus, has imposed unintendedpersonal life hurdles and major social constraints on cognitively impaired older adults. Many of theseindividuals are dependent on community-based services for care and support and therefore face greatchallenges to performing essential social activities, including attending community-based exercise classes.Given that the signs of the outbreak abating are still vague and that there is the likelihood of new outbreak thiswinter, the continued enforced societal isolation will exacerbate sedentary behaviors in a population withalready low levels of physical activity and poor physical and mental health outcomes. Objectives. Thisapplication requests Administrative Supplement to support the development and testing of an Internet-basedexercise intervention (Tai Ji Quan Moving to Improve Brain Health [TJQMIBH]) using real-timevideoconferencing for older adults with mild cognitive impairment (MCI). The proposed work aligns with thescope of our parent project (AG059546), which is designed to evaluate the efficacy of an in-person, group-based, cognitive-motor-integrated Tai Ji Quan intervention for this vulnerable and at-risk population. The fundsfrom this Administrative Supplement will support research work related to the following four specific aims:Specific Aim 1: to transform the in-person TJQMIBH intervention protocol into a deliverable online classprotocol; Specific Aim 2: to pilot test the online TJQMIBH virtual class delivery protocol in older adults withMCI; Specific Aim 3: To develop effective and protected online assessment and data ascertainmentprocedures encompassing the cognitive and physical performance measures; and Specific Aim 4: to conducta randomized controlled trial comparing the effectiveness of the virtual TJQMIBH intervention with a stretchingexercise control group among older adults with MCI. Significance and Impact. Shelter-in-place and social-distancing policies in response to COVID-19 have left older adults with cognitive impairment with few or noopportunities to continue physical activity in their community. Evidence suggests that limited or no physicalactivity may lead to an increased risk and potential worsening of chronic health conditions for this at-riskpopulation. Meanwhile, there are few Internet-based exercise programs available to keep older adults activeand healthy in the highly contagious COVID-19 environment. Our project addresses this urgent public healthneed by developing and delivering a virtual exercise program at home through the Internet. If successful, theoutcome from this project will exert a sustained, powerful influence on the field of disease prevention byproviding a safe, accessible, and effective exercise intervention for older adults with cognitive impairment thatcan be implemented both under current extreme conditions and in the aftermath of the COVID-19 pandemic.