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eCAM Advance Access originally published online on December 1, 2004
eCAM 2004 1(3):223-232; doi:10.1093/ecam/neh048
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© 2004, the authors Evidenced-based Complementary and Alternative Medicine, Vol. 1, Issue 3 © Oxford University Press 2004; all rights reserved. The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated.

Review

Shingles Immunity and Health Functioning in the Elderly: Tai Chi Chih as a Behavioral Treatment

Michael Irwin1,*, Jennifer Pike1 and Michael Oxman2

1Cousins Center for Psychoneuroimmunology, University of California Los Angeles Neuropsychiatric Institute Los Angeles, CA, USA, and 2Department of Medicine and Pathology, University of California San Diego and the San Diego Veterans Affairs Medical Center San Diego, CA, USA.

Both the incidence and severity of herpes zoster (HZ) or shingles increase markedly with increasing age in association with a decline in varicella zoster virus (VZV)-specific immunity. Considerable evidence shows that behavioral stressors, prevalent in older adults, correlate with impairments of cellular immunity. Moreover, the presence of depressive symptoms in older adults is associated with declines in VZV-responder cell frequency (VZV-RCF), an immunological marker of shingles risk. In this review, we discuss recent findings that administration of a relaxation response-based intervention, tai chi chih (TCC), results in improvements in health functioning and immunity to VZV in older adults as compared with a control group. TCC is a slow moving meditation consisting of 20 separate standardized movements which can be readily used in elderly and medically compromised individuals. TCC offers standardized training and practice schedules, lending an important advantage over prior relaxation response-based therapies. Focus on older adults at increased risk for HZ and assay of VZV-specific immunity have implications for understanding the impact of behavioral factors and a behavioral intervention on a clinically relevant end-point and on the response of the immune system to infectious pathogens.

Keywords: behavioral treatment – elderly – shingles – tai chi chih – immunity health status

*For reprints and all correspondence: Michael Irwin, MD, Norman Cousins Professor, Cousins Center for Psychoneuroimmunology, UCLA Neuropsychiatric Institute, 300 Medical Plaza, Suite 3-109, Los Angeles, CA 90095-7057, USA. Tel: +1-310-825-8281. Fax: +1-310-794-9247. Email: mirwin1{at}ucla.edu


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