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Title: Qigong exercise enhances cognitive functions in the elderly via an interleukin-6-hippocampus pathway : a randomized active-controlled trial
Authors: Qi, D
Wong, NML
Shao, R
Man, ISC
Wong, CHY
Yuen, LP
Chan, CCH 
Lee, TMC
Issue Date: Jul-2021
Source: Brain, behavior, and immunity, July 2021, v. 95, p. 381-390
Abstract: Background: Evidence has suggested that exercise protects against cognitive decline in aging, but the recent lockdown measures associated with the COVID-19 pandemic have limited the opportunity for outdoor exercise. Herein we tested the effects of an indoor exercise, Qigong, on neurocognitive functioning as well as its potential neuro-immune pathway.
Methods: We conducted a 12-week randomized active-controlled trial with two study arms in cognitively healthy older people. We applied Wu Xing Ping Heng Gong (Qigong), which was designed by an experienced Daoist Qigong master, to the experimental group, whereas we applied the physical stretching exercise to the control group. The Qigong exercise consisted of a range of movements involving the stretching of arms and legs, the turning of the torso, and relaxing, which would follow the fundamental principles of Daoism and traditional Chinese medicine (e.g., Qi). We measured aging-sensitive neurocognitive abilities, serum interleukin-6 (IL-6) levels, and brain structural volumes in the experimental (Qigong, n = 22) and control groups (stretching, n = 26) before and after the 12-week training.
Results: We observed that Qigong caused significant improvement in processing speed (t (46) = 2.03, p = 0.048) and sustained attention (t (46) = -2.34, p = 0.023), increased hippocampal volume (t (41) = 3.94, p < 0.001), and reduced peripheral IL-6 levels (t (46) = -3.17, p = 0.003). Moreover, following Qigong training, greater reduction of peripheral IL-6 levels was associated with a greater increase of processing speed performance (bootstrapping CI: [0.16, 3.30]) and a more significant training-induced effect of hippocampal volume on the improvement in sustained attention (bootstrapping CI: [-0.35, −0.004]).
Conclusion: Overall, these findings offer significant insight into the mechanistic role of peripheral IL-6—and its intricate interplay with neural processes—in the beneficial neurocognitive effects of Qigong. The findings have profound implications for early identification and intervention of older individuals vulnerable to cognitive decline, focusing on the neuro-immune pathway.
Keywords: Aging
Gray matter volume
Publisher: Academic Press
Journal: Brain, behavior, and immunity 
ISSN: 0889-1591
EISSN: 1090-2139
DOI: 10.1016/j.bbi.2021.04.011
Rights: © 2021 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (
The following publication Qi, D., Wong, N. M., Shao, R., Man, I. S., Wong, C. H., Yuen, L. P., ... & Lee, T. M. (2021). Qigong exercise enhances cognitive functions in the elderly via an interleukin-6-hippocampus pathway: A randomized active-controlled trial. Brain, Behavior, and Immunity, 95, 381-390 is available at
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