Cognitive Frailty
Conditions
Brief summary
The goal of this clinical trial is to investigate the effects of chair exercise followed by intergenerational activity in frailty syndrome and changes in serum mBDN levels among older adults with Physio-Cognitive Decline Syndrome (PCDS), as a novel approach integrating physical and social intervention with biomolecular assessments In older adults with PCDS 1. Does A 16-week program of chair exercise followed by intergenerational activity improve handgrip strength (HGS), gait speed, MoCA-Ina scores, and health-related quality of life? 2. Does a 16-week program of chair exercise followed by an intergenerational activity increase serum mBDNF level? 3. Are serum mBDNF levels associated with MoCA-Ina scores, gait speed, and handgrip strength? Intervention Group Participants will undergo a 12-week structured chair exercise program, conducted with a trained exercise instructor and supervised by a physician for vital sign monitoring during each session. The frequency of sessions will increase progressively: * Weeks 1-2: once weekly * Weeks 3-6: twice weekly * Week 7-12: three times weekly Additional activities include (intervention and control group): * Weeks 1 and 11: teleconference session on nutrition and physical exercise supported by electronic flyers (e-flyers). * Weeks 3, 5, 7, 11, and 13: distribution of e-flyers on elderly nutrition and the muscle-brain axis. Additional Activity (intervention group) \- Weeks 13-16: intergenerational activities at an orphanage with children aged \>5 years Assessments (intervention and control group): * Week 1: serum mBDNF and HbA1c measurement * Week 12 and 16: physical assessments (body weight, height, handgrip strength, gait speed, MoCA-Ina, and IADL) and serum mBDNF measurement. Control Group: The participant will receive general health education on performing physical exercise 1-3 times per week throughout week 1-16
Detailed description
Population aging in Indonesia has led to a growing proportion of older adults experiencing functional and cognitive decline. Physio-cognitive decline syndrome (PCDS), defined as the coexistence of reduced physical performance (such as slow gait speed or weak handgrip strength) and mild cognitive impairment without disability or dementia, is considered an early and reversible stage that increases the risk of frailty, disability, and poor quality of life. Chair exercise provides a safe and feasible intervention for older adults, with proven benefits in muscle strength, balance, and neurocognitive function, partly mediated through increased levels of brain-derived neurotrophic factor (BDNF). In parallel, an intergenerational activity involving direct interaction between older and younger individuals has shown promise in improving psychosocial well-being and cognitive outcomes. This study integrates chair exercise with intergenerational activities to target the multidimensional nature of PCDS. Outcomes will focus on frailty status and changes in serum mature brain-derived neurotrophic factor (mBDNF) to establish a multimodal, culturally adapted strategy to support healthy aging in Indonesian older adults.
Interventions
BEHAVIORALIntervention 1
Nutritional education + 12 weeks structured chair-based exercise (PEROSI protocol, progressive frequency from 1 to 3 sessions/week, 60 minutes/session, supervised online) followed sequentially by 4 weeks SHP-based intergenerational activities (8 sessions, 2x/week, 45 minutes/session, paired 1:1 elderly-child using AMIR educational materials at selected orphanages).
Sponsors
Atma Jaya Catholic University of Indonesia
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Aged 60-75 years * Meet diagnostic criteria for physio-cognitive decline syndrome (PCDS): gait speed \<1.0 m/s and/or hand grip strength \<28 kg (men) or \<18 kg (women), and MoCA-Ina score 22-26 * Instrumental Activities of Daily Living (IADL) score \>5 * Able to understand and follow instructions adequately * Willing to participate and provide written informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frailty Syndrome Status | From enrollment to the end of treatment at 12 weeks | • Change in frailty syndrome status (assessed using Cardiovascular Health Study criteria: score 0 robust, 1-2 pre-frail, ≥3 frail) from baseline to week 16. |
| serum mature brain-derived neurotrophic factor (mBDNF) | from baseline to week 16 | Change in serum mature brain-derived neurotrophic factor (mBDNF) levels (measured by ELISA) from baseline to week 16. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hand grip strength | from baseline to week 16 | Change in hand grip strength (in kilogram; dominant hand, best of 3 trials using hand dynamometer) from baseline to week 16. |
| Gait Speed Test | baseline to week 16 | Change in gait speed (m/s; average of 2 trials over 6-meter walk test) from baseline to week 16. |
| Cognitive Function | from baseline to week 16 | Change in cognitive function (MoCA-Ina total score, range 0-30) |
| health-related quality of life (SF-12 questionnaire) | from baseline to week 16 | Change in health-related quality of life (SF-12 questionnaire) |
| serum mBDNF levels | baseline to week 16 | Correlations between changes in serum mBDNF levels and changes in MoCA-Ina score, hand grip strength, and gait speed. |
Countries
Indonesia
Outcome results
None listed