Comparative effect of Tai Chi and aerobic exercise on cognitive function in advanced lung cancer survivors with perceived cognitive impairment: a three-arm randomized controlled trial with mediation analysis

Naomi Takemura; Denise Shuk Ting Cheung; Daniel Yee Tak Fong; Anne Wing Mui Lee; Tai-Chung Lam; James Chung-Man Ho; Tsz Yeung Kam; Jeannie Yin Kwan Chik; Chia-Chin Lin

doi:10.1007/s11764-024-01607-1

Comparative effect of Tai Chi and aerobic exercise on cognitive function in advanced lung cancer survivors with perceived cognitive impairment: a three-arm randomized controlled trial with mediation analysis

J Cancer Surviv. 2024 May 1. doi: 10.1007/s11764-024-01607-1. Online ahead of print.

Authors

Affiliations

¹ School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
² Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Guangdong, China.
³ Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
⁴ Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
⁵ Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
⁶ Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong.
⁷ School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong. chia.chin.lin@hku.hk.
⁸ Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Pokfulam, Hong Kong. chia.chin.lin@hku.hk.

PMID: 38691272
DOI: 10.1007/s11764-024-01607-1

Abstract

Purpose: Cancer-related cognitive impairment is prevalent in metastatic lung cancer survivors. This study aimed to compare the effectiveness of aerobic exercise and Tai Chi on perceived cognitive function and the mediating role of psychoneurological symptoms with perceived cognitive impairment.

Methods: In a subgroup of a parent randomized clinical trial, participants who reported cognitive impairment underwent a 16-week aerobic exercise (n = 49), Tai Chi (n = 48), and control (n = 54) groups. Measures included perceived cognitive function and psychoneurological symptoms (sleep disturbance, fatigue, anxiety, and depression) assessed at baseline (T0), 16-week (T1), and 1 year (T2).

Results: Participants in Tai Chi showed significant improvements compared to aerobic exercise and control groups in perceived cognitive function at T1 (AE: between-group difference, 6.52; P < 0.001; CG: 8.34; P < 0.001) and T2 (AE: between-group difference, 3.55; P = 0.05; CG: 5.94; P < 0.001). Sleep disturbance, fatigue, anxiety, and depression at month 12 explained 24%, 31%, 32%, and 24% of the effect of the intervention on cognitive function at month 12, respectively. Only anxiety at month 4 explained 23% of the intervention effect at month 12.

Conclusions: Tai Chi demonstrated beneficial effects on cognitive function in advanced lung cancer survivors with perceived cognitive impairment. Improvement in cognitive function was mediated by reducing sleep disturbance, fatigue, anxiety, and depression, highlighting the importance of addressing these symptoms in future interventions to improve cognitive function, with anxiety playing a significant role at an earlier stage.

Implications for cancer survivors: Tai Chi is a potentially safe complementary therapeutic option for managing cognitive impairment in this vulnerable population.

Trial registration: ClinicalTrials.gov identifier: NCT04119778; retrospectively registered on 8 October 2019.

Keywords: Aerobic exercise; Cognitive function; Lung cancer; Randomized controlled trial; Tai Chi.

Associated data

ClinicalTrials.gov/NCT04119778