| Author: | Tam, Chung Ying |
| Title: | Effects of e-health enhanced motor-cognitive training on cognitive function, physical frailty, and physical function of accident and emergency department discharged community-dwelling older adults with cognitive frailty : a pilot randomised controlled trial |
| Advisors: | Cheung, Daphne (SN) Kwan, Rick (SN) |
| Degree: | DHSc |
| Year: | 2024 |
| Subject: | Frail older people -- Care Older people -- Care Self-help devices for older people Assistive computer technology Exercise therapy for older people Hong Kong Polytechnic University -- Dissertations |
| Department: | Faculty of Health and Social Sciences |
| Pages: | xiii, 143 pages : color illustrations |
| Language: | English |
| Abstract: | Background: Motor-cognitive training effectively reverses and prevents further deterioration of cognitive function, frailty status, and physical function in older adults with cognitive frailty. Recent systematic reviews have shown that older adults with cognitive frailty are more likely to develop dementia and experience falls than those with frailty alone. The current time-pressured Accident and Emergency Department (AED) setting is challenging for practitioners to provide an intervention to maintain or improve the current physical and cognitive function of these older adults with non-acute complaints and prone to further deterioration after AED discharge. There is a mismatch between the services offered by traditional emergency medicine and the demands of the elderly population. Specific intervention is required to better target the needs of these older adults. Based on a systematic review and previous literature, motor-cognitive training is an essential intervention component. However, the effects of motor-cognitive training in a home setting are unknown. Aims: This study aims to explore the feasibility of an e-health enhanced motor-cognitive intervention for emergency department-discharged community-dwelling older adults with cognitive frailty and to evaluate the effectiveness of the interventions on (1) cognitive function, (2) physical function and (3) frailty status. Methods: This study is a single-blinded pilot randomised controlled study. Subjects were allocated to either the intervention or control group in a 1:1 ratio, receiving motor-cognitive training in addition to usual care or usual care only. The programme targeted older adults aged 60 or above with cognitive frailty who had been discharged from the AED. The intervention lasted 12 weeks, with three 90-minute sessions (60 minutes of physical activity and 30 minutes of cognitive training) per week. The primary outcome was feasibility, including compliance, adherence, and adverse effects. The secondary outcome was intervention efficacy, which included physical frailty level, physical performance, and cognitive function. Data was collected at two time points: baseline and post-intervention. The findings of the study might help improve the actual research and provide evidence for implementing motor-cognitive training for AED discharged older adults with cognitive frailty. Results: Of the 241 AED discharged patients who were screened, 58 who met the eligibility criteria were invited, while 18 patients declined participation. Forty participants consented to participate and were randomised into either the intervention group (n=20) or the control group (n=20). The recruitment and retention rates were 17% and 90%, respectively. Significant differences were observed in frailty status, cognitive function, and physical performance in within-group comparison of the intervention group. Additionally, the duration spent on moderate to vigorous physical activity was significantly higher in the intervention group compared to the control group in post-intervention assessment. Conclusion: This study employed e-health enhanced motor-cognitive training for AED discharged older adults with cognitive frailty in community settings. The findings indicate that e-health enhanced motor-cognitive training was clinically feasible and showed a positive preliminary effect on frailty status, cognitive function, and physical performance. |
| Rights: | All rights reserved |
| Access: | restricted access |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 7999.pdf | For All Users (off-campus access for PolyU Staff & Students only) | 2.77 MB | Adobe PDF | View/Open |
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