Tai Chi/Qigong for Subsyndromal Depression and Cognition in Older Age Bipolar Disorder

Study Overview
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Brief Summary
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It is expected that by 2030, the percentage of patients with bipolar disorder (BD) in Canada over 60 years of age will exceed 50%. In this population, poor cognition and persistent sub-threshold depressive symptoms are particularly common, difficult to treat, associated with increased mood episodes, and poor daily functioning. Mind-body interventions have increasingly been found to be effective in treating several psychiatric condition including BD. A few pilot studies examining mindfulness-based intervention in younger adult BD have been promising for depressive symptoms, but some pilot research suggest that patients with older age bipolar disorder (OABD) may benefit more from moving mindfulness. The investigators will conduct a 12-week randomized controlled trial to assess whether tai-chi/qigong will be associated with 1) greater reduction in depressive symptoms, and 2) greater improved cognition, in comparison to a light exercise active control condition, 12- and 24-weeks from baseline, in BD patients aged 40+.

Official Title
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Efficacy of Tai Chi/Qigong for Subsyndromal Depression and Cognition in Older Age Bipolar Disorder: A Pilot Randomized Controlled Trial With an Active Control

Conditions
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Bipolar Disorder

Intervention / Treatment
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* Behavioral: Tai Chi/Qigong vs. Walking/Stretching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged greater than or equal to 40 years history of diagnosis of bipolar I or II disorder access to a computer with a functioning camera, microphone, and ability to run Zoom software English or French speaking ability to give informed consent Exclusion Criteria: Young Mania Rating Scale score > 5 current clinician diagnosis of substance abuse, unless currently in complete remission risk of suicide as assessed by a score above 3 on item 10 of Montgomery Asberg Depression Rating Scale participation or plan to participate in any other concurrent psychosocial group program during course of study unstable psychiatric medication (less than 4-weeks since commencement)

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Tai Chi and Qigong<br>50mins x 12 weeks of virtually-delivered group tai chi/qigong | Behavioral: Tai Chi/Qigong vs. Walking/Stretching<br>* Both interventions can be thought of as a form of movement and exercise.<br>|
| Active Comparator: Walking and Stretching<br>50mins x 12 weeks of virtually-delivered group walking and stretching | Behavioral: Tai Chi/Qigong vs. Walking/Stretching<br>* Both interventions can be thought of as a form of movement and exercise.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Depression | Level of depression as measured by the Montgomery-Asberg Depression Rating Scale, at 12-weeks and 24-weeks post-intervention. Possible score range: 0-60, higher score indicates worse outcome | Baseline, 12-weeks, 24-weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Processing Speed | Processing speed as measured by the Animal Fluency Test at 12-weeks and 24-weeks. Scored by number of animals named, higher score indicates better outcome. | Baseline, 12-weeks, 24-weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mindfulness, older age bipolar disorder, tai chi, qigong, randomized controlled trial