The goal of this clinical trial is to learn if active Physical activity + virtual reality cognitive therapy (aPAVRCT) works to slow the progression of AD cognitive decline in older adults. It will also learn about the physical effects and mental effects of the aPAVRCT. The main questions it aims to answer are:
Does aPAVRCT slow the progression of AD cognitive decline? (e.g., HK-MoCA, ADAS-Cog) Does aPAVRCT improve physical function? (e.g., ADL) Does aPAVRCT improve mental health? (e.g., GDS-15, PANAS) Does aPAVRCT improve life satisfaction? Does aPAVRCT improve other cognitive or physical capacities? What issues and benefits do participants and stakeholders (e.g., families, caregivers, managers) have when taking aPAVRCT? (e.g., NPI-Q) Researchers will compare the intervention group (aPAVRCT) to a control group (rehabilitation bike) to see if aPAVRCT works to slow the progression of AD in cognitive decline.
Participants will:
Take aPAVRCT (interventional group) or usual physical acitvity (control group) at least twice a week, 15 minutes for each session, for 12-16 weeks Physiotherapies (assistants) and care professionals will do the intervention, research group will operate, observe, and assist the experiment.
All the experiment processes will be recorded. Visit the sites everyday for checkups and tests Keep a diary of their symptoms, the number of times, and any essential information
Sites: around 3-5 nursing homes, under one institution. Inclusion criteria: older adults in the setting who have the ability to pedal a rehabilitation bike.
older adults in the setting who have the ability to pedal the rehabilitation bike
Individuals self-reporting or identified by stakeholders as unwilling or unsuitable to participate.
Parallel
aPAVRCT
Behavioral* We offered a system integrated with an indoor bike (for physical activity) and a multisensory VR environment (for cognitive training, such as reminiscence). * Participants will actively navigate the virtual environment by pedaling and steering the handlebar. * Care professionals will deliver the intervention using this system.
Hong Kong - Montreal cognitive assessment scale
MoCA is a cognitive assessment method for dementia, particularly mild stages of cognitive impairment. (range, 0-30, with lower scores indicating greater cognitive impairment)
The Integrated Alzheimer's Disease Rating Scale (iADRS)
iADRS (range, 0-144, with lower scores indicating greater cognitive and functional described impairment) is to assess both cognitive and physical functions for dementia, combines the 13-item cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-Cog13 ), the Alzheimer's Disease Cooperative Study-Instrumental Activities of Daily Living Inventory (ADCS-iADL).
Mini-Mental State Examination (MMSE)
For cognitive assessment, (range: 0-144, with lower scores indicating greater cognitive impairment)
Time up and Go Test
TUG test evaluates fall risk, mobility and physical performance in the elderly
Sit to Stand Test
sit to stand test is a test that evaluates the functional strength of the lower extremity, balance and fall risk.
Geriatric depression scale (GDS-15)
Geriatric depression scale identifies possible depression in older adults. Range: 0-15, with higher scores indicating greater possible depression.
The Cornell Scale for Depression in Dementia (CSDD)
CSDD is to assess changes in a person's mood, behaviours and routines which may be symptoms of depression. Range: 0-38, with higher scores indicating greater depression symptoms
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