Managing Stress and Social Ties for Health Aging

Study Overview
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Brief Summary
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There has been a dramatic rise from 46% to 59% in the percentage of households with only 1-2 people from 1970 to 2000. A 40% increase in the number of people living alone is projected for 2010. Social isolation is consistently one of the strongest predictors mortality in older adults. Recent research is demonstrating that stress plays an important role linking social isolation with poor health. Socially isolated older adults are more likely to feel chronically stressed and overwhelmed with everyday life demands. Furthermore, isolated adults respond to stress differently, both psychologically and physiologically. Socially isolated and lonely older adults show long-term elevations in inflammatory cytokines, which are signaling molecules related by immune cells. These Inflammatory cytokines play a role in a number of age-related diseases including cardiovascular disease, type-2 diabetes and arthritis. Novel, readily useable interventions aimed at decreasing isolation and re-calibrating stress responses might be helpful to older adults. Tai Chi is an ancient Chinese form of calisthenics that promotes relaxation and decreases feelings of stress and as such, it may be a useful intervention for socially isolated, stressed older adults. However, its effects on stress responses are unknown. Tai Chi Chih (TCC) is a simplified, manualized, readily exportable form of Tai Chi particularly well-suited for older adults. This proposed study will test the effects of a TCC intervention with socially isolated older adults on loneliness, stress and health outcomes, including inflammatory assessment. Tai Chi-naïve participants who perceive themselves as socially isolated, as measured by the UCLA Loneliness Scale will be randomized to receive either Tai Chi or education control for a 12-week period. Subjects will undergo pre- and post-intervention stress assessment, including exposure to a psychological stress task, to assess whether Tai Chi affects how subjects physiologically and psychologically respond to stress.

Official Title
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Managing Stress and Social Ties for Health Aging

Conditions
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Stress

Intervention / Treatment
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* Behavioral: Tai Chi Chih
* Behavioral: Stress Education Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults > 60 years old Have not done Tai Chi before Live in Los Angeles area Socially isolated Women must be post menopausal Exclusion Criteria: Any physical debility that limits Tai Chi performance; Cognitive impairment (< 23 on the Mini-Mental State Exam); Current or recent history of smoking Immune suppression resulting from neoplastic disease Corticosteroid use or other therapy Significant underlying illness that would interfere or prevent completion of the study Acute conditions (e.g. viral infection w/in 2 weeks) that might confound interpretation of inflammatory data Current or recent (within 1 month) use of illicit drugs.

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Tai Chi Chih<br>12 weeks of physical exercise in the form of Tai Chi Chih | Behavioral: Tai Chi Chih<br>* 12 weeks of weekly classes of Tai Chi Chih<br>* Other names: relaxation;|
| Active Comparator: Stress Education Control<br>Stress management education | Behavioral: Stress Education Control<br>* Weekly meetings, for 2 hours for 12 weeks discussing issues related to stress education.<br>* Other names: stress information;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived Stress |  | 4-8 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Autonomic Activity and inflammatory signalling |  | 4-8 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stress, loneliness, social isolation, autonomic activity, inflammation, Perceived social isolation, Chronic stress