Background: Cognitive frailty is a state that combines physical weakness and cognitive impairment. As age increases, the prevalence rate also increases. Older adults with cognitive frailty are prone to falls, limited or degraded physical functions, and are at high risk of becoming disabled. It is an essential predictor of dementia and mortality. There are currently very few randomized controlled trial studies on cognitive frailty abroad. Although there are many related studies on senile frailty in Taiwan, most studies examine cognitive function and physical frailty separately. Since cognitive frailty is reversible, early intervention can delay or prevent the occurrence of cognitive frailty. Therefore, cognitive-motor dual tasks are introduced. For more information, see the effectiveness of dual-tasking in cases of cognitive decline.
Purpose: Goal is to not only explore the feasibility of a motor-cognition dual-task program for elderly individuals with cognitive frailty but also to compare its impact on cognitive and physical function with existing training programs. By doing so, the purpose of this study will be to provide practical insights that can inform the development of effective interventions for this vulnerable population.
Methods: A randomized clinical trial was used to explore the effectiveness of a dual-task intervention program on cognitive function and physical activity in older adults with cognitive frailty. Eligible subjects were recruited through convenience sampling and randomly assigned to two groups. The experimental group used Nintendo Switch to perform dual tasks of motor cognition, while the control group performed regular activities. Twice a week, 60 minutes each time, for eight weeks of training. Both groups completed basic information (demographics, disease characteristics, and lifestyle), cognitive function measurements, and physical activity function measurements in the pre-test (T0) in the 4th week (T1) and 8th week (T2). Cognitive function measurements and physical activity function measurements were performed again. Using SPSS 29.0 as a statistical tool, independent sample t-test and Chi-square test were used to detect the demographic variables, disease treatment variables, living habits, cognitive functions, and physical effects of the two groups-homogeneity of activities. A generalized estimating equation (GEE) was used as a statistical method to process and analyze repeated measurement data. The effects of the inter-group and time interaction on the two groups' cognitive function and physical activity were studied differently.
Expected research results: This study is expected to construct a suitable dual-task program to introduce the role of physical and cognitive function in this group and explore its effectiveness.
Aged 65 years or older
Subjective cognitive decline (measured by SMC with a score of at least 1 point) or mild cognitive impairment (measured by MoCA-T with a score of ≤25 points)
Possessing characteristics of physiological frailty (meeting at least one of the above items as measured by FFI)
Diagnosed with Alzheimer's disease or other types of dementia
Suffering from musculoskeletal diseases and severe mental illness that make it impossible to perform cognitive and motor tasks
Parallel
Dual tasks of digital technology
Other interventionThe intervention activities of this study were cognitive and physical activity training using Nintendo Switch twice a week, 60 minutes each time (5 minutes of warm-up and cool-down exercises, 10 minutes of stretching exercises, and 40 minutes of exercise combined with cognitive training) for a total of 8 weeks. train. Both groups filled in basic data (demographics and disease characteristics) and underwent cognitive function measurements and physical activity function measurements at pretest (T0), 4th week (T1), and 8th week (T2).
Taiwanese version of the Montreal Cognitive Assessment (MoCA-T)
This scale is used to assess the cognition funtion. The internal consistency Cronbach's coefficient of this tool is 0.83 and the test-retest reliability is 0.92.
Taiwanese version of the Montreal Cognitive Assessment (MoCA-T)
This scale is used to assess the cognition funtion. The internal consistency Cronbach's coefficient of this tool is 0.83 and the test-retest reliability is 0.92.
Taiwanese version of the Montreal Cognitive Assessment (MoCA-T)
This scale is used to assess the cognition funtion. The internal consistency Cronbach's coefficient of this tool is 0.83 and the test-retest reliability is 0.92.
Taiwan Odd-Even Number Sequencing Test (TOENS)
This scale is used to assess the cognition funtion. It's Half-reliability ranged from 0.69 to 0.95, and the test-retest reliability was 0.75.
Timed Up and Go (TUG)
This tool is used to assess physical activity function. The reliability of the tool is 0.96
Timed Up and Go (TUG)
This tool is used to assess physical activity function. The reliability of the tool is 0.96
Timed Up and Go (TUG)
This tool is used to assess physical activity function. The reliability of the tool is 0.96
Short Physical Performance Battery (SPPB)
This tool is used to assess physical activity function. The test-retest reliability of the SPPB was good: 0.87 (CI 95%: 0.77-0.96)
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