Study protocol for a comparative randomized controlled trial of Tai Chi and conventional exercise training on alleviating depression in older insomniacs

Author: Francesco Recchia1, Angus P Yu1, Teryn C Ng1, Daniel Y Fong2, Derwin K C Chan3, Calvin P Cheng4, Stanley S C Hui5, Chenchen Wang6,7, Parco M Siu1
Affiliation: <sup>1</sup> Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong China. <sup>2</sup> School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong China. <sup>3</sup> Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong China. <sup>4</sup> Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong China. <sup>5</sup> Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong China. <sup>6</sup> Division of Rheumatology, Allergy &amp; Immunology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA. <sup>7</sup> Center for Complementary and Integrative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Conference/Journal: J Exerc Sci Fit
Date published: 2024 Jul 1
Other: Volume ID: 22 , Issue ID: 3 , Pages: 194-201 , Special Notes: doi: 10.1016/j.jesf.2024.03.001. , Word Count: 258


Background:
Insomnia and depression are prevalent mental disorders that are often comorbid among older adults. Lifestyle intervention strategies incorporating Tai Chi or conventional exercise have been shown to alleviate symptoms of insomnia and depression. However, the comparative efficacy of these exercise modalities in individuals with both disorders has yet to be determined. Therefore, the aim of this study is to examine the efficacy of Tai Chi and conventional exercise for reducing depressive symptoms in older adults with chronic insomnia and depressive symptoms, when compared to a health education control.

Methods:
This study is a prospective, assessor-blinded, three-arm, parallel group, randomized controlled trial. Older adults aged ≥60 years with a diagnosis of chronic insomnia and depressive symptoms will be randomly assigned to a Tai Chi, conventional exercise or health education control condition on a 1:1:1 basis. Interventions will last for 3 months, with a 6-month follow-up period. The primary outcome is depressive symptoms, assessed using the Hospital Anxiety and Depression Scale. Secondary outcomes include subjective sleep quality, 7-day actigraphy, 7-day sleep diary, anxiety symptoms, quality of life, medication usage and physical function. All measurements will be conducted at baseline, 3 months and 9 months by outcome assessors who are blinded to group allocation.

Discussion:
This study will compare the efficacy of Tai Chi and conventional exercise in improving depression outcomes in older adults with chronic insomnia and depressive symptoms. Our results will shed light on the clinical potential of these interventions for combating insomnia and depression in older adults.

Keywords: Depressive symptoms; Exercise; Insomnia; Older adults; Tai Chi.

PMID: 38559906 PMCID: PMC10979278 DOI: 10.1016/j.jesf.2024.03.001