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Effects of a Behavioral Intervention, Tai Chi Chih, on Varicella-Zoster Virus Specific Immunity and Health Functioning in Older Adults

Irwin, Michael R. MD; Pike, Jennifer L. PhD; Cole, Jason C. PhD, and; Oxman, Michael N. MD

doi: 10.1097/01.PSY.0000088591.86103.8F

Objective Both the incidence and severity of herpes zoster (shingles) increase markedly with increasing age in association with a decline in varicella-zoster virus (VZV) specific cell-mediated immunity (CMI). This study examined whether a behavioral intervention, Tai Chi Chih (TCC), affects VZV specific immunity and health functioning in older adults who, on average, show impairments of health status and are at risk for shingles.

Methods Thirty-six men and women (age ≥60 years) were assigned randomly to a 15-week program of TCC instruction (three 45 minute classes per week; N = 18) or a wait list control condition (N = 18). VZV-specific CMI was measured at baseline and at 1-week postintervention. Health functioning (Medical Outcome scale: SF-36) was assessed at baseline, and at 5, 10, and 15 weeks during the intervention, and at 1-week postintervention.

Results In the intent-to-treat sample, VZV-specific CMI increased 50% from baseline to 1-week postintervention in the TCC group (p < 0.05) but was unchanged in the wait list control group. In those who completed the study, 1-week postintervention SF-36 scale scores for role-physical (p < 0.05) and physical functioning (p < 0.05) were higher in the TCC group (N = 14) as compared with controls (N = 17). Older adults who had impairments of physical status at baseline showed the greatest increases of SF-36 role-physical (p < 0.01) and physical functioning (p < 0.001) during the TCC intervention.

Conclusions Administration of TCC for 15 weeks led to an increase in VZV-specific CMI. Gains in health functioning were found in participants who received TCC and were most marked in those older adults who had the greatest impairments of health status.

From the Cousins Center for Psychoneuroimmunonology (M.R.I., J.L.P., J.C.C.), UCLA Neuropsychiatric Institute, University of California, Los Angeles; and Department of Medicine (M.N.O.), University of California, San Diego and San Diego Veterans Affairs Healthcare System, San Diego, California.

Address reprint requests to: Michael Irwin, MD, Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, 300 UCLA Medical Plaza, Suite 3-109, Los Angeles, CA 90095-7057. Email:

Received October 19, 2002; revision received February 19, 2003.

Copyright © 2003 by American Psychosomatic Society
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