One goal of the study is to evaluate the efficacy of qigong to alleviate depressive symptoms and enhance cognitive function in comparison to mindfulness-based intervention, physical exercise, and waitlist control. The other goal is to explore the changes in neurobiological markers that may explain the qigong-related effects on depressive symptoms and cognitive function. The main research questions are:
* Is the 12-week qigong training more effective than mindfulness-based intervention, physical exercise, and waitlist control to alleviate depressive symptoms? * Is the 12-week qigong training more effective than mindfulness-based intervention, physical exercise, and waitlist control to enhance cognitive function?
Participants are older adults aged 60 or above. They were randomly assigned to qigong training, mindfulness training, physical exercise training, or wait-list which all last for 12 weeks. Their changes before and after the 12-week period in depressive symptoms, neurobiological markers, and cognitive functions are assessed.
60 years or older;
With mild or severer levels of depressive symptoms as indicated by the Geriatric Depression Scale (GDS-8) scores of 5 or above, or Depression Anxiety and Stress Scale-21 (DASS-21) depression subscale scores of 4 or above
Self-identified as physically stable and without life-threatening diseases.
Be able to communicate in Cantonese or Mandarin.
Have a history of practicing or receiving training of any form of mind-body or regular exercises (including tai chi, yoga, and qigong, or regular physical activity > 3 times/week) during the month prior to intervention
Have changed medications or the dose of medications prescribed for their health condition in the one month prior to study enrollment
Have severe cognitive or language impairment based on the assessment with Montreal Cognitive Assessment (MoCA)
Taking medication or undergoing electroconvulsive therapy, psychotherapy, or psychoeducation for a psychological or psychiatric condition
Parallel
Qigong (Baduanjin)
BehavioralParticipants will receive 24 sessions of Baduanjin training over 12 weeks (2 sessions per week). Each session will last for 60 minutes. Baduanjin consists of eight forms of gentle movements, and it takes about 10 to 15 minutes to complete a full cycle. Participants will learn to practice each form gradually over the first 12 sessions. In the remaining 12 sessions, the participants will go through all the movements 2-3 times, with guided practice on rhythmic breathing and mind regulation (attention to body and breathing) to be performed in coordination with the movements. The training will be delivered by an instructor after training by the project team.
Mindfulness-based intervention
BehavioralParticipants will receive mindfulness-based intervention with the same duration and frequency as qigong group. The intervention incorporates psychoeducation on mindfulness and stress management and group-based mindfulness practice about breathing, awareness of body sensations, thoughts, stretching, and walking. All the mindfulness practices are based on publicly accessible audio recordings. The training will be delivered by an instructor after training by the project team.
Physical exercise
BehavioralParticipants of the physical exercise group will receive training of a series of low-to-moderate intensity physical activities for the same duration and frequency as qigong group. The physical activities include stretching, flexibility exercise, balance exercise, and aerobic exercise. The training will be delivered by an instructor after training by the project team.
Depressive symptoms
The eight-item Patient Health Questionnaire
Global cognitive function
Montreal Cognitive Assessment
Serum adiponectin
Collected and assayed through peripheral blood sample
Serum BDNF
Collected and assayed through peripheral blood sample
Salivary cortisol
Collected and assayed through saliva sample
Attention
Attention Network Task
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