Is Tai Chi effective in reducing depressive symptoms among older adults?
Date of publication of the systematic review: January 2013
Design
Systematic review of 4 randomized controlled trials (RCTs).
Participants
253 older adults (age range: 52 to 85 years, male% 36%) with depressive symptoms. Participants diagnosed with comorbidities that did not carry a direct effect on depressive symptoms were also included.
Intervention
Tai Chi intervention, ranging from 2 to 5 times a week with 1 to 3 hour per session, for 12 to 24 weeks.
Comparator
Comparison 1: Tai Chi versus waiting list control;
Comparison 2: Tai Chi versus control receiving no exercise prescription.
Major Outcomes
Outcome 1: Reduction in depressive symptoms scale scores as measured at week 12.
Settings
2 trials were conducted in community settings, 1 trial was in outpatient setting and another trial was conducted in both inpatient and outpatient settings.
Comparison    Tai Chi versus waiting list control
Main Results
Compared to waiting list control, Tai Chi showed significant reduction in depressive scale scores (pooled standardized mean difference (pooled SMD): -0.27, 95% CI: -0.52 to -0.02).
Comparison 1: Tai Chi versus waiting list control among elderly at week 12
Outcomes No. of studies (Total number of participants) Standardized mean/ No. of participants Heterogeneity test (I2) Pooled SMD (95% CI) Overall quality of evidence*
Intervention Comparator
1 4(253) 0.9/ 139 1.17/ 114 0% -0.27 (-0.52 to -0.02) Moderate
Keys: SMD = standardized mean difference; CI = confidence interval.
Comparison    Tai Chi versus control receiving no exercise
Main Results
Compared to control group receiving no exercise prescription, Tai Chi did not show significant reduction in depressive scale scores (pooled standardized mean difference (pooled SMD): -0.31, 95% CI: -0.68 to 0.06).
Comparison 2: Tai Chi versus control receiving no exercise prescription among elderly at week 12
Outcomes No. of studies (Total number of participants) Standardized mean/ No. of participants Heterogeneity test (I2) Pooled SMD (95% CI) Overall quality of evidence*
Intervention Comparator
1 2(116) 1.06/ 63 1.38/ 53 0% -0.31 (-0.68 to 0.06) Low
Keys: SMD = standardized mean difference; CI = confidence interval.
Comparison    Tai Chi versus waiting list control
Main Results
Compared to waiting list control, Tai Chi showed significant reduction in depressive scale scores (pooled standardized mean difference (pooled SMD): -0.27, 95% CI: -0.52 to -0.02).
Comparison 1: Tai Chi versus waiting list control among elderly at week 12
Outcomes 1
No. of studies (Total number of participants) 4(253)
Standardized mean/ No. of participants Intervention 0.9/ 139
Comparator 1.17/ 114
Pooled SMD (95% CI) -0.27 (-0.52 to -0.02)
Overall quality of evidence* Moderate
Keys: SMD = standardized mean difference; CI = confidence interval.
Comparison    Tai Chi versus control receiving no exercise
Main Results
Compared to control group receiving no exercise prescription, Tai Chi did not show significant reduction in depressive scale scores (pooled standardized mean difference (pooled SMD): -0.31, 95% CI: -0.68 to 0.06).
Comparison 2: Tai Chi versus control receiving no exercise prescription among elderly at week 12
Outcomes 1
No. of studies (Total number of participants) 2(116)
Standardized mean/ No. of participants Intervention 1.06/ 63
Comparator 1.38/ 53
Pooled SMD (95% CI) -0.31 (-0.68 to 0.06)
Overall quality of evidence* Low
Keys: SMD = standardized mean difference; CI = confidence interval.
Conclusion
Benefits
Compared to waiting list control, Tai Chi was effective for reducing depressive scale scores. However, compared to control receiving no exercise prescriptions, Tai Chi did not outperform in reducing depressive rating scores among elderly. For the outcome in comparison 1, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect. For the outcome in comparison 2, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were reported in the included trials.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pubmed/22680972
The synopsis is based on the following article:
Chi I, Jordan-Marsh M, Guo M, Xie B, Bai Z. Tai Chi and reduction of depressive symptoms for older adults: a meta-analysis of randomized trials. Geriatr Gerontol Int. 2013 Jan;13(1):3-12.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.