A Study Of Baduanjin On Cerebral Hemodynamics In The Older Adults With Cognitive Frailty

Objective: To explore the effect of Baduanjin on cerebral hemodynamics,cognitive function,physical function and quality of life in the older adults with Cognitive Frailty(CF),and whether the effect of Baduanjin intervention on cerebral blood flow changes is related to the changes of cognitive and physical function related indicators.Methods: Using randomized controlled study design,102 eligible participants were selected from three communities in Fuzhou and randomly assigned to control group and Baduanjin group.Control group received health education once a month for no less than 30 minutes each time.On the basis of health education,Baduanjin group received Baduanjin exercise intervention for 24 weeks,60 minutes each time,3 times a week.Before intervention and 24 weeks after intervention,Transcranial Doppler,Montreal Cognitive Assessment Scale(Mo CA),Edmonton Frail Scale(EFS)and Quality of Life Assessment Scale(SF-36)were used to measure cerebral hemodynamics parameters,global cognitive function,physical frailty status,and quality of life of subjects in both groups.The difference t-test analysis method and mixed linear model were used to analyze the differences of cerebral hemodynamic parameters,global cognitive function,physical frailty status and quality of life between the two groups.Partial correlation was used to explore the relationship between the improvement of cognitive function and physical function of Baduanjin and the changes of cerebral hemodynamics in the elderly with CF.All statistical analyses were performed in SPSS 24.0.Results:1.Global cognitive function and physical function: after 24 weeks of intervention,the total score of Mo CA in Baduanjin group was significantly higher than that in control group(2.51 ± 0.32 vs 0.34 ± 0.44,P<0.001),while the EFS score in Baduanjin group was significantly lower than that in control group(-1.94±0.20 vs-1.16±0.23,P=0.012).The total score of Mo CA and EFS score had significant difference in the effect value of group effect,time effect,group and time interaction effect(P<0.05),and Baduanjin group was better than the control group.2.Cerebral hemodynamic parameters:(1)Difference t-test analysis showed that after 24 weeks of intervention,peak systolic velocity(PSV)of the right middle cerebral artery slowed down in Baduanjin group Significantly lower than control group(-1.31±1.66 vs-8.48±2.23,P=0.046),mean blood flow velocity(BFVmean)of the right middle cerebral artery speeded up in Baduanjin group was significantly faster than control group(1.65±1.49 vs-4.61±1.61,P=0.029),PSV of the left middle cerebral artery slowed down in Baduanjin group significantly lower than control group(-2.97±2.12 vs-8.21±1.50,P=0.022),and PSV of the left posterior cerebral artery speeded up in Baduanjin group was significantly faster than control group(2.99±1.72 vs-1.88±1.70,P=0.048),PSV of the basilar artery slowed down in Baduanjin group significantly lower than control group(-1.28 ± 1.99 vs-6.74 ± 2.33,P=0.024),BFVmean of basilar artery speeded up in Baduanjin group was significantly faster than control group(0.22±0.93 vs-3.78±1.55,P=0.041),and end diastolic velocity(EDV)of basilar artery speeded up in Baduanjin group was significantly faster than control group(1.05±0.76 vs-2.53±1.18,P=0.012),difference of other cerebral hemodynamic parameters was not statistically different(P>0.05).(2)Mixed linear model analysis showed that: compared with control group,Baduanjin group had significant group and time interaction effect on PSV,BFVmean and EDV of the right middle cerebral artery(P=0.012,P=0.005,P=0.019),there was significant interaction effect on PSV of the left middle cerebral artery and the left posterior artery(P=0.045,P=0.048),and there was significant interaction effect on BFVmean and EDV of the basilar artery(P=0.029,P=0.012).3.Quality of life: After 24 weeks of intervention,the energy score of Baduanjin group was significantly higher than that of control group(0.69±0.73 vs-1.86±1.05,P=0.048);In the mixed linear model analysis,the energy score of Baduanjin group had significant group effect(P=0.011),group and time interaction effect(P=0.048),and there was no significant difference in other dimensions(P>0.05).4.Correlation analysis showed that: peak systolic velocity of the left posterior cerebral artery in Baduanjin group had a significant negative correlation with the change of the total Mo CA score(r=-0.308,P=0.047);There was no correlation between the changes of cerebral hemodynamic parameters and the changes of frailty scale scores(P>0.05).Conclusions:1.Regular Baduanjin exercise can significantly improve the global cognitive function and physical function of the elderly with cognitive frailty,and improve their quality of life.2.Regular Baduanjin can significantly improve the PSV,BFVmean,EDV of the right middle cerebral artery,the PSV of the left middle cerebral artery,the PSV of the left posterior cerebral artery,and the PSV,BFVmean,EDV of the basilar artery in the elderly with CF.3.Regular Baduanjin exercises can improve the cognitive function of the elderly with CF,which may be related to the improvement of the hemodynamic parameters of the PSV of the left posterior cerebral artery.