Middle-aged and Older Adults

Healthy foods, including peanuts, may improve brain function, which is essential for cognitive and metabolic health, and may contribute to improved food intake regulation. It is therefore important to investigate the specific effects of peanut butter on cerebral blood flow responses, as well as the potential associated functional benefits. The researchers hypothesize that long-term peanut butter consumption improves vascular function in the brain, thereby enhancing cognitive performance and appetite control in middle aged and older adults. Objective: The primary objectives are to investigate in middle aged and older men and women the effect of 16-week peanut butter consumption on brain vascular function, while we will also assess changes in cognitive performance and appetite-related brain reward activity (secondary objectives). Cerebral blood flow responses (brain vascular function) will be non-invasively quantified by the non-invasive gold standard magnetic resonance imaging (MRI)-perfusion method Arterial Spin Labeling (ASL).Study design: This intervention study will have a randomized, controlled, cross-over design. The total study duration will be 40 weeks, including two 16-week interventions, separated by a washout period of at least 8 weeks. Study population: Forty-five middle-aged and older men and women (aged 45-75 years) without a history of cardiovascular diseases or complaints will participate. This population is expected to have a decreased cerebral blood flow at baseline and are also at increased risk of cognitive impairment, allowing for improvement by the intervention. Intervention: Study participants will receive, in random order, 45 g of peanut butter daily (peanut intervention) or no peanut butter (control) for a total of 16 weeks, separated by a wash-out period of at least 8 weeks. Main study parameters/endpoints: At baseline, first anthropometric measurements will be performed and blood pressure will be determined. In addition, a fasting blood sample will be drawn. Another fasting blood sample will be drawn at eight weeks, while participants have to attend the research facilities to perform follow-up measurements after sixteen weeks. The primary endpoint is the difference at follow-up in the cerebral blood flow response between peanut butter intervention and control periods. Cognitive performance will be assessed, while the researchers will also focus on appetite-related brain reward activity (secondary outcomes).

This study aims to develop and evaluate a smart nursing AI agent to support health self-management among middle-aged and older patients, and further to examine its effectiveness in home care and health self-management. The goal is to propose innovative strategies for middle-aged and older care that enhance the quality of home care and strengthen patients' health self-management abilities. A randomized controlled trial design will be adopted, with a planned enrollment of 102 participants. Participants will be randomly assigned to either the experimental group or the control group. Regardless of group assignment, their routine medical care will remain unchanged. Both groups will participate in the study for 12 weeks (8 weeks of intervention and 4 weeks of follow-up), with identical frequency and number of follow-ups, interviews, and evaluations. The experimental group will receive an 8 week intervention using the smart nursing AI agent care model, which provides daily interaction, reminder systems, personalized recommendations, activity monitoring, goal setting, motivational support, and health self-management education. The control group will continue with the existing standard health education approach. Data collection will include demographic information, medical history, physiological indicators, functional activity measures (e.g., steps, distance, exercise duration), sarcopenia screening, nutritional assessment, physical activity levels, health self-management ability, health literacy, quality of life, and digital usage behaviors. Statistical analyses will be conducted to evaluate the effectiveness, feasibility, and acceptability of the intervention.