The journals of gerontology. Series A, Biological sciences and medical sciences · 2026
A technology-blended exercise intervention for cognitive risk reduction and brain health in middle-aged and older adults with type 2 diabetes in Singapore: a mixed-methods study.
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Zhang Jinghua, Tam Wilson Wai San, Lu Jinhua, Chen Junjie, Montayre Jed, Kusuyama Joji, Dong Yanhong, Yap Xin Yi, Zhou Wentao, Wang Na, Yeo Hui Nan, Lee Frena Jia Sy, Wu Vivien Xi
Аннотация
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a major modifiable risk factor for accelerated brain ageing, cognitive decline, and dementia. However, sustainable lifestyle interventions targeting cognitive health in at-risk older adult populations remain limited. This mixed-methods study evaluated the effects of a 12-week technology-blended Intensive Aerobic and Resistance Exercise Program (IAREP) on cognitive risk and related health outcomes among middle-aged and older adults with T2DM in a primary care setting in Singapore.
METHODS: Participants were recruited from a community polyclinic and allocated to either the intervention or usual care group. The intervention integrated face-to-face, Zoom-based, and video-recorded home exercise sessions to support accessibility and adherence. Quantitative outcomes included cognitive impairment (CI) risk, physical function, metabolic and inflammatory markers, physical activity, and self-care maintenance. Qualitative focus group discussions (FGDs) explored participant experiences following program completion.
RESULTS: Fifty-three participants completed the study (mean age 66.7 years). Compared with usual care, the intervention group demonstrated significant reductions in predicted risk of CI (F(1,51) = 4.9, p = .031, η²p = 0.088), improvements in physical function (F(1,51) = 10.6, p = .002, η²p = 0.172), and higher physical activity levels (F(1,51) = 8.3, p = .006, η²p = 0.140). Self-care maintenance also improved significantly (F(1,51) = 4.5, p = .040, η²p = 0.081). Adherence was high (88.9%). Qualitative findings highlighted enhanced motivation, social connectedness, and perceived cognitive and physical well-being.
CONCLUSIONS: These findings support technology-blended exercise might be a feasible and scalable strategy for cognitive risk reduction and brain health promotion among middle-aged and older adults with T2DM, with potential translational relevance for dementia prevention in primary care and community settings.
CLINICAL TRIAL REGISTRATION NUMBER: NCT06401733.
METHODS: Participants were recruited from a community polyclinic and allocated to either the intervention or usual care group. The intervention integrated face-to-face, Zoom-based, and video-recorded home exercise sessions to support accessibility and adherence. Quantitative outcomes included cognitive impairment (CI) risk, physical function, metabolic and inflammatory markers, physical activity, and self-care maintenance. Qualitative focus group discussions (FGDs) explored participant experiences following program completion.
RESULTS: Fifty-three participants completed the study (mean age 66.7 years). Compared with usual care, the intervention group demonstrated significant reductions in predicted risk of CI (F(1,51) = 4.9, p = .031, η²p = 0.088), improvements in physical function (F(1,51) = 10.6, p = .002, η²p = 0.172), and higher physical activity levels (F(1,51) = 8.3, p = .006, η²p = 0.140). Self-care maintenance also improved significantly (F(1,51) = 4.5, p = .040, η²p = 0.081). Adherence was high (88.9%). Qualitative findings highlighted enhanced motivation, social connectedness, and perceived cognitive and physical well-being.
CONCLUSIONS: These findings support technology-blended exercise might be a feasible and scalable strategy for cognitive risk reduction and brain health promotion among middle-aged and older adults with T2DM, with potential translational relevance for dementia prevention in primary care and community settings.
CLINICAL TRIAL REGISTRATION NUMBER: NCT06401733.