BOCA RATON, Fla. (EGMN) – Tai chi can make a significant difference in older patients with major depression as an add-on to antidepressant medication, according to a pilot study.

Researchers randomized 73 partial responders to escitalopram (Lexapro) to a modified form of tai chi chih or health education for 2 hr/wk. Both groups demonstrated improvements in HAM-D (Hamilton Rating Scale–Depression) scores, but the tai chi chih cohort demonstrated significantly greater resilience to stress, as well as improvements in health-related quality of life and cognitive function.

“I’m encouraged. This is a simple intervention available to everyone,” Dr. Helen Lavretsky said. “I am particularly excited about changes in memory and cognition, especially executive functioning.”

This is the first randomized study to assess tai chi for geriatric depression, Dr. Lavretsky said. Studies in the literature already support tai chi in older populations for balance (Gait Posture 2007;25:205-14) and quality of life (J. Altern. Complement. Med. 2007;13:1077-83).

The Tai chi chih was shorter and was combined with breathing techniques for this population of people aged 60 years and older. “Some older people have arthritis, but this modified form was not difficult for them to do,” Dr. Lavretsky said in an interview at her poster during the New Clinical Drug Evaluation Unit meeting sponsored by the National Institute of Mental Health.

Keep in mind that seniors with severe pain are precluded from participation in tai chi, she added.

The tai chi chih group reported increased energy levels. “Psychomotor retardation is very common in older adults who are very sedentary. Tai chi got them going,” said Dr. Lavretsky, a geriatric psychiatrist at the University of California, Los Angeles.

The investigators proposed that this complementary mind-body intervention would reduce stress, improve physical functioning, and reduce the risk for polypharmacy in this population. They noted that fewer than 50% of elderly depressed patients who are treated with first-line antidepressant therapy achieve remission and functional recovery.

An initial 112 participants with major depression were treated with 10 mg escitalopram per day for 6 weeks. The 73 partial responders then continued this regimen; of these, 36 were randomized to tai chi chih and another 37 to health education for 10 weeks.

“The educational group did well, also. There was initial parallel improvement in HAM-D [24-item] scores,” Dr. Lavretsky said. Both groups experienced a mean improvement of 6.0 in scores on this measure.

However, at week 16 the tai chi chih group demonstrated significantly greater improvements in resiliency, compared with the health education group, Dr. Lavretsky said. They also had a significantly higher mean score of 80 on the SF-36 Health Survey (an instrument that measures patient health), compared with 66 in the health education group. A higher score corresponds to a higher health-related quality of life.

In addition, their executive cognitive function was better at 16 weeks than was that of the health education group. For example, the tai chi chih group had a mean Stroop test errors score of 0.03, compared with a mean 0.32 score in the education group. They also scored higher on the California Verbal Learning Test long-delayed recall at week 16 (a mean of 11.6), compared with 9.7 in the health education group.

The study was funded by the National Center for Complementary and Alternative Medicine. Dr. Lavretsky said she had no relevant disclosures.