Wong Arkers Kwan Ching, Zhang Melissa Qian, Bayuo Jonathan, Chow Karen Kit Sum, Wong Siu Man, Wong Bonnie Po, Liu Bob Chung Man, Lau David Chi Ho, Kowatsch Tobias
School of Nursing, The Hong Kong Polytechnic University, Hung Hom, China (Hong Kong).
Hong Kong Lutheran Social Service, Homantin, China (Hong Kong).
JMIR Serious Games. 2024 Nov 20;12:e57352. doi: 10.2196/57352.
The aging population highlights the need to maintain both physical and psychological well-being. Frailty, a multidimensional syndrome, increases vulnerability to adverse outcomes. Although physical exercise is effective, adherence among older adults with frailty is often low due to barriers. Motion-based video games (MBVGs) may enhance motivation and engagement.
This study aims to evaluate the effect of individualized exercise programs that combine MBVGs, intergenerational support, and therapeutic frameworks on physical, cognitive, and social frailty outcomes in community-dwelling older adults.
This randomized controlled trial was conducted from March 2022 to October 2023 across 6 community centers in Hong Kong. Participants aged 60 years and above with mild neurocognitive disorder were recruited, screened, and randomly assigned to either an intervention (n=101) or control group (n=101). The intervention included an 18-week program with 12 supervised exercise sessions utilizing motion-based technology, led by occupational therapists and assisted by youth volunteers. Data were collected at baseline (T1) and postintervention (T2), focusing on physical, cognitive, and social frailty outcomes, as well as client-related metrics. Statistical analyses were performed using SPSS, with significance set at P<.05.
A total of 202 participants were recruited, with a mean age of 78.8 years (SD 7.8). Both groups showed improvements in balance from T1 to T2, with a significant time effect (β=-0.63, P=.03). The intervention group demonstrated enhancements in hand strength and BMI, but no statistically significant between-group differences were observed. The intervention group also exhibited significant improvements in cognitive function (β=2.43, P<.001), while the control group's scores declined. Short-term memory improved for both groups, with no significant differences noted. Both groups experienced a reduction in depression levels, with a significant within-group effect at T2 (β=-1.16, P=.001). Improvements in social connectedness and eHealth literacy were observed in both groups, with the latter showing a significant within-group effect at T2 (β=3.56, P=.002). No significant effects were found for social isolation, physical activities, or quality of life.
The growing aging population necessitates innovative strategies to support aging in place. Results indicated statistically significant improvements only in BMI and cognition, while other outcomes such as loneliness, balance, and eHealth literacy showed positive trends but lacked significance. Despite the limitations observed, particularly regarding the role of volunteer support and the diverse needs of community-dwelling older adults, the findings contribute to the foundation for future research aimed at enhancing biopsychosocial outcomes. Future studies should explore tailored interventions that consider individual preferences and abilities, as well as evaluate specific components of motion-based video games to optimize their effectiveness.
人口老龄化凸显了维持身心健康的必要性。衰弱是一种多维度综合征，会增加不良后果的易感性。尽管体育锻炼有效，但由于存在障碍，体弱的老年人对其依从性往往较低。基于运动的视频游戏（MBVG）可能会增强动机和参与度。
本研究旨在评估结合MBVG、代际支持和治疗框架的个性化运动计划对社区居住的老年人身体、认知和社会衰弱结果的影响。
本随机对照试验于2022年3月至2023年10月在香港的6个社区中心进行。招募了60岁及以上患有轻度神经认知障碍的参与者，进行筛选并随机分配到干预组（n=101）或对照组（n=101）。干预包括一个为期18周的计划，其中有12次由职业治疗师主导、青年志愿者协助的基于运动技术的监督锻炼课程。在基线（T1）和干预后（T2）收集数据，重点关注身体、认知和社会衰弱结果以及与客户相关的指标。使用SPSS进行统计分析，显著性设定为P<0.05。
共招募了202名参与者，平均年龄为78.8岁（标准差7.8）。两组从T1到T2在平衡方面均有改善，具有显著的时间效应（β=-0.63，P=0.03）。干预组在手力量和体重指数方面有提高，但组间差异无统计学意义。干预组在认知功能方面也有显著改善（β=2.43，P<0.001），而对照组的得分下降。两组的短期记忆均有所改善，无显著差异。两组的抑郁水平均有所降低，在T2时具有显著的组内效应（β=-1.16，P=0.001）。两组在社会联系和电子健康素养方面均有改善，后者在T2时具有显著的组内效应（β=3.56，P=0.002）。在社会隔离、身体活动或生活质量方面未发现显著影响。
不断增长的老年人口需要创新策略来支持就地养老。结果表明，仅在体重指数和认知方面有统计学意义的显著改善，而其他结果如孤独感、平衡和电子健康素养虽呈积极趋势但缺乏显著性。尽管观察到存在局限性，特别是关于志愿者支持的作用和社区居住老年人的多样化需求，但这些发现为未来旨在改善生物心理社会结果的研究奠定了基础。未来的研究应探索考虑个人偏好和能力的量身定制的干预措施，并评估基于运动的视频游戏的具体组成部分以优化其有效性。
