Tai chi versus traditional exercise for physical and cognitive health in middle-aged and older adults: a systematic literature review

Naluri Denay; Juanda Putra

doi:10.32698/03162

Tai chi versus traditional exercise for physical and cognitive health in middle-aged and older adults: a systematic literature review

Naluri Denay⁽¹⁾, Juanda Putra⁽²⁾,
(1) Universitas Negeri Padang

Indonesia
(2) Universitas Negeri Padang

Indonesia

Corresponding Author

DOI : https://doi.org/10.32698/03162

Full Text:

Language : en

Abstract

People are living longer, and with that comes a growing need to stay active so we don't lose our physical and mental health as we age. Yet where Tai Ji Quan fits among other kinds of exercise is still an open question. Most studies so far simply haven't paid enough attention to how an active exercise stacks up against Tai Ji Quan. We ran a systematic literature search built around combinations of Tai Chi, comparison exercise, older population, and health outcomes. The Scopus database gave us 403 articles. Papers were eligible only if they were written in English, appeared between 2022 and 2026, and either reported results or laid out the procedure in detail, meaning they described what the researchers planned to do. On top of that, each one had to compare Tai Chi with some form of active traditional exercise in people aged 50 or over. After we dropped the duplicates, 388 papers remained. We scanned all of them against our inclusion criteria, read 72 full texts, and in the end only 18 studies made it in. Tai Chi came out with clear effects on balance, flexibility, fall risk and related outcomes, plus certain aspects of brain function. Strength and endurance, on the other hand, improved more with walking and resistance training. So the evidence doesn't point decisively to one winner. It points instead to this: the right exercise depends on what you're trying to achieve. Going forward, researchers need to agree on how to measure and report the dose or frequency of Tai Chi their participants actually do. They also need to follow up on the effects of Tai Qi over a longer period, and the samples themselves should draw from a wider range of people.

Keywords

Tai Chi, Traditional exercise, Older adults, Physical function, Cognitive health

References

Ahmadinejad, B., Bahramian, F., Mousavi, S. A., & Jalali, A. (2024). Identify the most effective elderly preventive falling interventions using MCDM technique. Physical and Occupational Therapy in Geriatrics, 42(1), 53–69. https://doi.org/10.1080/02703181.2023.2238766

Bai, X., Wang, Y., Geok, S. K., Jin, Z., Xiao, W., & Zhang, J. (2025). Effects of different exercises on health-related physical fitness among middle-aged and elderly women. Frontiers in Psychology, 16, 1631702. https://doi.org/10.3389/fpsyg.2025.1631702

Bai, X., Xiao, W., Soh, K. G., Agudamu, & Zhang, Y. (2023). 12-week concurrent brisk walking and Taijiquan (Tai Chi) improve balance, flexibility, and muscular strength of Chinese older women. PLoS ONE, 18(10 October), e0293483. https://doi.org/10.1371/journal.pone.0293483

Chen, C., Saito, T., Wang, L., Yatsugi, H., Gong, Z., Li, S., & Kishimoto, H. (2025). Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial. BMC Complementary Medicine and Therapies, 25(1), 367. https://doi.org/10.1186/s12906-025-05100-9

Chen, X. S., Liu, H. Z., Fang, J., Wang, S. J., Han, Y. X., Meng, J., Han, Y., Zou, H. M., Gu, Q., Hu, X., Ma, Q. W., & Huang, F. (2025). Effects of Tai Chi on Cognitive Function in Older Adults With Type 2 Diabetes Mellitus: Randomized Controlled Trial Using Wearable Devices in a Mobile Health Model. Journal of Medical Internet Research, 27, e77014. https://doi.org/10.2196/77014

Chen, Y., Jin, C., Tang, H., Yu, J., Wang, Y., Chen, S., Miao, W., Zhang, S., & Wang, X. (2024). Effects of sedentary behaviour and long-term regular Tai Chi exercise on dynamic stability control during gait initiation in older women. Frontiers in Bioengineering and Biotechnology, 12, 1353270. https://doi.org/10.3389/fbioe.2024.1353270

Chen, Y., Wan, A., Mao, M., Sun, W., Song, Q., & Mao, D. (2022). Tai Chi practice enables prefrontal cortex bilateral activation and gait performance prioritization during dual-task negotiating obstacle in older adults. Frontiers in Aging Neuroscience, 14, 1000427. https://doi.org/10.3389/fnagi.2022.1000427

De Paz-Montón, L. P., Carmona-Torres, J. M., López-Fernández-Roldán, Á., Molina-Madueño, R. M., Navarrete-Tejero, C., & Laredo-Aguilera, J. A. (2026). Physical exercise programmes to improve insomnia or poor sleep quality in non-hospitalised elderly people: a systematic review and meta-analysis. PeerJ, , 1–25. https://doi.org/10.7717/peerj.20764

Dong, Y., Pang, D., Xiang, J., Chao, G., & Kuang, X. (2025). Exploring the benefits of traditional Chinese exercises (Tai Chi and Qigong) on the anxiety and depression of older adults A systematic review and meta-analysis. Medicine (United States), 104(12). https://doi.org/10.1097/MD.0000000000041908

Flores-Bello, C., Correa-Muñoz, E., Sánchez-Rodríguez, M. A., Rosado-Pérez, J., Vaquero-Barbosa, N., & Mendoza-Núñez, V. M. (2026). Effect of Tai Chi vs. Strength Training on Body Composition, Physical Performance, and Well-Being in Community-Dwelling Older Mexican Women. Healthcare (Switzerland), 14(5), 663. https://doi.org/10.3390/healthcare14050663

Gao, R., Greiner, C., Ryuno, H., & Zhang, X. (2024). Effects of Tai Chi on physical performance, sleep, and quality of life in older adults with mild to moderate cognitive impairment. BMC Complementary Medicine and Therapies, 24(1), 423. https://doi.org/10.1186/s12906-024-04705-w

Guo, B., Li, Y., Xu, G., Tang, X., & Zhai, Q. (2026). Research progress and trend of aerobic exercise intervention in patients with knee osteoarthritis: A knowledge mapping study based on bibliometrics. Medicine (United States), 105(4). https://doi.org/10.1097/MD.0000000000043691

Huang, H. P., Kuo, C. C., Lu, S. H., Chen, S. C., Ho, T. J., & Lu, T. W. (2022). Synergistic multi-joint kinematic strategies to reduce tripping risks during obstacle-crossing in older long-term Tai-Chi Chuan practitioners. Frontiers in Aging Neuroscience, 14, 961515. https://doi.org/10.3389/fnagi.2022.961515

Jones, D. L., Selfe, T. K., Wilcox, S., Cosner, C. T., Mitchell, J., Ray, B. D., Stipec, C., Switay, D., & Mancinelli, C. A. (2023). Falls and Fall-Related Injuries in an Evidence-Based Tai Ji Quan Intervention in Rural West Virginia Churches. Topics in Geriatric Rehabilitation, 39(3), 170–178. https://doi.org/10.1097/TGR.0000000000000398

Kang, N., Wang, Y., Chen, G., Guo, C., Zhang, Z., Mei, D., Morrow-Howell, N., & Wang, D. (2022). Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis. Sports Medicine and Health Science, 4(4), 239–244. https://doi.org/10.1016/j.smhs.2022.10.001

Kuo, C. C., Chen, S. C., Chen, T. Y., Ho, T. J., Lin, J. G., & Lu, T. W. (2022). Effects of long-term Tai-Chi Chuan practice on whole-body balance control during obstacle-crossing in the elderly. Scientific Reports, 12(1), 2660. https://doi.org/10.1038/s41598-022-06631-8

Lee, S. Y., Nyunt, M. S. Z., Gao, Q., Gwee, X., Chua, D. Q. L., Yap, K. B., Wee, S. L., & Ng, T. P. (2022). Association of Tai Chi exercise with physical and neurocognitive functions, frailty, quality of life and mortality in older adults: Singapore Longitudinal Ageing Study. Age and Ageing, 51(4), afac086. https://doi.org/10.1093/ageing/afac086

Li, T. Y., Yu, A. P., Hui, S. S., Chan, D. K., Cheng, C. P., Fong, D. Y., Irwin, M. R., & Siu, P. M. (2026). Effects of Tai Chi and conventional exercise on improving cognitive performance in older adults with mild cognitive impairment: Study protocol for a randomized controlled trial. Mental Health and Physical Activity, 30, 100768. https://doi.org/10.1016/j.mhpa.2026.100768

Li, X., Gao, M., Chu, M., Huang, S., Fang, Z., Chen, T., Lee, C. Y., & Chiang, Y. C. (2023). Promoting the well-being of rural elderly people for longevity among different birth generations: A healthy lifestyle perspective. Frontiers in Public Health, 11, 1050789. https://doi.org/10.3389/fpubh.2023.1050789

Li, X., Huang, J., Deng, H., Liu, Z., Ruan, Y., Huang, Z., Chen, Y., Tao, L., Chen, L., & Tao, J. (2025). Two-year follow-up assessment of a randomized controlled trial evaluating the durability of Tai Chi on cognitive function in older adults with type 2 diabetes and mild cognitive impairment. Aging Clinical and Experimental Research, 37(1), 315. https://doi.org/10.1007/s40520-025-03218-x

Liang, I., Perkin, O., Williams, S., McGuigan, P., Thompson, D., & Western, M. J. (2024). The Efficacy of 12-Week Progressive Home-Based Strength and Tai-Chi Exercise Snacking in Older Adults: A Mixed-Method Exploratory Randomised Control Trial. Journal of Frailty and Aging , 13(4), 572–581. https://doi.org/10.14283/jfa.2024.32

Liang, Z., Ding, C., He, G., & Chen, S. (2026). Mapping global research trends of Tai Chi for sleep health: Scientometric insights and network-based perspectives. Complementary Therapies in Medicine, 98, 103365. https://doi.org/10.1016/j.ctim.2026.103365

Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Medicine, 6(7), e1000100. https://doi.org/10.1371/journal.pmed.1000100

Lim, C. L., Keong, N. L. S., Yap, M. M. C., Tan, A. W. K., Tan, C. H., & Lim, W. S. (2023). The effects of community-based exercise modalities and volume on musculoskeletal health and functions in elderly people. Frontiers in Physiology, 14, 1227502. https://doi.org/10.3389/fphys.2023.1227502

Lin, L., He, Y. X., Wen, Q., Liu, J. Y., Dai, Y., Fei, Y. Z., Li, H., Li, C. Q., & Zhou, H. (2025). Evaluation of the efficacy of Tai Chi on the cognitive function of patients with mild cognitive dysfunction and research on its mechanism. Frontiers in Aging Neuroscience, 17, 1435996. https://doi.org/10.3389/fnagi.2025.1435996

Liu, C. L., Cheng, F. Y., Wei, M. J., & Liao, Y. Y. (2022). Effects of Exergaming-Based Tai Chi on Cognitive Function and Dual-Task Gait Performance in Older Adults With Mild Cognitive Impairment: A Randomized Control Trial. Frontiers in Aging Neuroscience, 14, 761053. https://doi.org/10.3389/fnagi.2022.761053

Liu, T., Wang, C., Sun, J., Chen, W., Meng, L., Li, J., Cao, M., Liu, Q., & Chen, C. (2022). The Effects of an Integrated Exercise Intervention on the Attenuation of Frailty in Elderly Nursing Homes: A Cluster Randomized Controlled Trail. Journal of Nutrition, Health and Aging, 26(3), 222–229. https://doi.org/10.1007/s12603-022-1745-4

Liu, X. X., Wang, G., Zhang, R., Ren, Z., Wang, D., Liu, J., Wang, J., & Gao, Y. (2024). Sensory reweighting and self-motion perception for postural control under single-sensory and multisensory perturbations in older Tai Chi practitioners. Frontiers in Human Neuroscience, 18, 1482752. https://doi.org/10.3389/fnhum.2024.1482752

Ma, Y., Gow, B. J., Song, R., Rist, P. M., Hausdorff, J. M., Lipsitz, L. A., Manor, B., & Wayne, P. M. (2024). Long-term Tai Chi practice in older adults is associated with “younger” functional abilities. Aging Cell, 23(1), e14023. https://doi.org/10.1111/acel.14023

Meng, D., Guo, H., Liang, S., Tian, Z., Wang, R., Yang, G., & Wang, Z. (2022). Effectiveness of a Hybrid Exercise Program on the Physical Abilities of Frail Elderly and Explainable Artificial-Intelligence-Based Clinical Assistance. International Journal of Environmental Research and Public Health, 19(12), 6988. https://doi.org/10.3390/ijerph19126988

Mitzner, T. L., Remillard, E. T., & Mumma, K. T. (2022). Research-Driven Guidelines for Delivering Group Exercise Programs via Videoconferencing to Older Adults. International Journal of Environmental Research and Public Health, 19(13), 7562. https://doi.org/10.3390/ijerph19137562

Oh, H., Song, R., & Kim, S. J. (2023). Effects of 12-week Tai Chi program on physical function, depression, and quality of life among cognitively impaired older adults: a feasibility study. BMC Geriatrics, 23(1), 118. https://doi.org/10.1186/s12877-023-03840-2

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021a). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71

Page, M. J., Moher, D., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … McKenzie, J. E. (2021b). PRISMA 2020 explanation and elaboration: Updated guidance and exemplars for reporting systematic reviews. BMJ, 372, n160. https://doi.org/10.1136/bmj.n160

Peyrusqué, E., Buckinx, F., Kergoat, M. J., & Aubertin-Leheudre, M. (2023). Exercise Guidelines to Counteract Physical Deconditioning in Long-Term Care Facilities: What to Do and How to Do It?. Journal of the American Medical Directors Association, 24(5), 583–598. https://doi.org/10.1016/j.jamda.2023.01.015

Pillay, J., Gaudet, L. A., Saba, S., Vandermeer, B., Ashiq, A. R., Wingert, A., & Hartling, L. (2024). Falls prevention interventions for community-dwelling older adults: systematic review and meta-analysis of benefits, harms, and patient values and preferences. Systematic Reviews, 13(1), 289. https://doi.org/10.1186/s13643-024-02681-3

Qin, J., Huang, J., Liu, J., Chen, Y., Luo, J., Tao, L., Liu, Z., Liu, W., Xu, Y., Liang, S., Chen, C., Tang, Q., Chen, Z., Chen, S., Chen, L., & Tao, J. (2025). Effects of Tai Chi Chuan on balance function in adults 60 years or older with type 2 diabetes and mild cognitive impairment in China: A secondary analysis of a multi-center randomized clinical trial. Journal of Diabetes Investigation, 16(11), 2059–2069. https://doi.org/10.1111/jdi.70138

Qiu, J., Wang, J., Song, X., Shu, W., & Kim, S. M. (2026). Dose-Related Effects of Different Tai Chi Styles Versus Traditional Community-Based Exercises on Cardiometabolic Health and Physical Function in Middle-Aged and Older Adults: Randomized Controlled Trial. JMIR Aging, 9, e80125. https://doi.org/10.2196/80125

Recchia, F., Yu, A. P., Ng, T. C., Fong, D. Y., Chan, D. K., Cheng, C. P., Hui, S. S., Wang, C., & Siu, P. M. (2024). Study protocol for a comparative randomized controlled trial of Tai Chi and conventional exercise training on alleviating depression in older insomniacs. Journal of Exercise Science and Fitness, 22(3), 194–201. https://doi.org/10.1016/j.jesf.2024.03.001

Remillard, E. T., Mitzner, T. L., & Mumma, K. T. (2025). Tele Tai Chi for people aging with mobility disabilities: Novel methodology and structured adaptation approach. Contemporary Clinical Trials Communications, 47, 101543. https://doi.org/10.1016/j.conctc.2025.101543

Sari, Y. M., Hill, K. D., Lee, D. C. A., & Burton, E. (2023). Effectiveness of exercise programmes in improving physical function and reducing behavioural symptoms of community living older adults with dementia living in Asia, and impact on their informal carers: A systematic review and meta-analysis. Hong Kong Physiotherapy Journal, 43(1), 3–17. https://doi.org/10.1142/S101370252350004X

Sharma, P., Pratap, Y., Kumar, N., Mahto, P., Ghosh, S., & Sharma, V. (2025). Effect of the Otago Exercise Programme Combined With Tai Chi Exercises on Reducing the Risk of Fall in Elderly. Reabilitacijos Mokslai: Slauga, Kineziterapija, Ergoterapija, 2(33), 82–94. https://doi.org/10.33607/rmske.v2i33.1741

Smith, J., Jackson, T., Liu, W., Gelfond, J., & Hsiao, H. Y. (2025). Combined effects of Tai-Chi gait with mediolateral ground support perturbation on dynamic balance control. Sports Medicine and Health Science, 7(3), 208–213. https://doi.org/10.1016/j.smhs.2024.07.002

Song, X., Ali, N. M., Mhd Salim, M. H., & Rezaldi, M. Y. (2026). Immersive Tai Chi for Home-Based Exercise in Older Adults: Usability and Feasibility Study. JMIR Serious Games, 14, e79453. https://doi.org/10.2196/79453

Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 45. https://doi.org/10.1186/1471-2288-8-45

Tranfield, D., Denyer, D., & Smart, P. (2003). Towards a methodology for developing evidence-informed management knowledge by means of systematic review. British Journal of Management, 14(3), 207–222. https://doi.org/10.1111/1467-8551.00375

van Eck, N. J., & Waltman, L. (2010). Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics, 84(2), 523–538. https://doi.org/10.1007/s11192-009-0146-0

Wang, C., Liu, H., Gu, X., Han, J., Wang, B., & Wang, G. (2026). Rescuing gait under cognitive load: the benefits of Tai Chi for MCI. Frontiers in Physiology, 17, 1770084. https://doi.org/10.3389/fphys.2026.1770084

Wang, X., Liu, Y., Yin, Y., Huang, H., Chen, J., Chen, Z., Liu, S., Xiao, L., Chen, S., & Peng, C. (2026). The effects of structured aerobic exercise and mind–body exercise on cognitive function in older adults with MCI: Systematic review and meta-analysis. Medicine (United States), 105(10). https://doi.org/10.1097/MD.0000000000047633

Xu, F., Soh, K. G., Chan, Y. M., Bai, X. R., Qi, F., & Deng, N. (2023). Effects of tai chi on postural balance and quality of life among the elderly with gait disorders: A systematic review. PLoS ONE, 18(9 September), e0287035. https://doi.org/10.1371/journal.pone.0287035

Yu, C., Bian, D., Zhang, J., Han, X., Shi, C., & Li, G. (2025). Effect of Dual-Task Training on Cognitive Function in Community-Dwelling Older Adults With Mild Cognitive Impairment: Sequential Multiple Assignment Randomized Trial. Journal of Medical Internet Research, 27, e79274. https://doi.org/10.2196/79274

Zhang, X., Bao, J., Yang, H., Zhang, Z., Shu, D., & Luo, L. (2022). Effects of Tai Chi and Walking Exercise on Emotional Face Recognition in Elderly People: An ERP Study. Healthcare (Switzerland), 10(8), 1486. https://doi.org/10.3390/healthcare10081486

Zhang, Y., Song, Q., Li, X., Sun, W., Yv, B., Mao, D., & Mao, M. (2026). Long-Term Tai Chi Practice Modulates Cortical-Muscular Interactions During Walking in Older Adults: A Cross-Sectional Study. Clinical Interventions in Aging, 21, 615470. https://doi.org/10.2147/CIA.S615470

Zhang, Z. (2022). Tai Chi impacts on neuromuscular functions in the lower limbs of the elderly. Revista Brasileira de Medicina do Esporte, 28(5), 581–583. https://doi.org/10.1590/1517-8692202228052022_0015

Zhao, J., Han, W., & Tang, H. (2023). Lower limbs inter-joint coordination and variability during typical Tai Chi movement in older female adults. Frontiers in Physiology, 14, 1164923. https://doi.org/10.3389/fphys.2023.1164923