Establishment And Application Of A Community-based Exercise Intervention Program For Older Adults With Cognitive Impairment Based On Goal-setting Theory

Objectives:(1)To construct an exercise intervention program based on goalsetting theory suitable for older adults with cognitive impairment in the community.(2)To evaluate the effects of the intervention on physical activity level,adherence,exercise self-efficacy,exercise outcome expectancy,and cognitive function.Methods:(1)Firstly,through literature review,we initially constructed an exercise intervention program based on goal-setting theory suitable for older adults with cognitive impairment in the community;conducted qualitative interviews with older adults with cognitive impairment in the community to understand the acceptance of the intervention program,suggestions,and barriers to participation in the study;conducted expert group meetings to obtain suggestions from relevant experts on the intervention program;the final version of the exercise intervention program was modified and finalized through a pre-experiment to understand the perceptions of the elderly with cognitive impairment in the community about the exercise intervention program.(2)A randomized controlled trial was adopted to select two communities in Changsha City,Hunan Province,to recruit older adults with cognitive impairment who met the inclusion and exclusion criteria.The study lasted 12 weeks,with health education for the control group and an exercise intervention based on goal-setting theory for the experimental group.Physical activity scale for elderly(PASE),Numeric rating scale(NRS),Exercise self-efficacy scale(ESS),and Outcome expectations for elderly(OEE),subjective cognitive decline questionnaire(SCD-Q9),Montreal cognitive assessment(Mo CA),and the incidence of adverse events were evaluated for both groups at baseline(T0)and within one week after the end of the intervention(T1).Excel 2019 was used for data entry and organization,SPSS 26.0 for data analysis,and descriptive analysis,independent samples t-test,and nonparametric Mann-Whitney U test were used for statistical analysis.Results:(1)The final version of the exercise intervention program included a home exercise intervention program and an exercise behavior intervention program,in which the home exercise intervention program included warmup exercises,aerobic exercises,resistance exercises,acupressure point tapping,and flexibility exercises.The exercise behavior intervention program based on goal-setting theory included health education to improve the cognitive ability of the participants to achieve their goals,supervising the subjects to sign a goal commitment form,and personalizing the exercise goal setting for the subjects with feedback and resources needed to achieve the exercise goals.(2)A total of 79 older adults with subjective cognitive decline and mild cognitive impairment who met the inclusion and exclusion criteria were included in this randomized controlled study,40 in the trial group and39 in the control group.The intervention was implemented for a total of 12 weeks,during which one case in the trial group and two cases in the control group dropped out,resulting in a total of 76 older adults completing the intervention.When the two groups were compared at baseline(T0),it was found that there was no statistically significant difference between the general information and outcome indicators of the study subjects(P > 0.05),and the groups were balanced and comparable.When the two groups were compared within one week after the end of the intervention(T1),the total scores of PASE,NRS,ESS,and Mo CA in the test group were higher than those in the control group(P < 0.05),and no adverse events such as hypoglycemia and falls occurred in the study subjects in both the test and control groups.In the pre-and post-intervention comparison,the total scores of PASE,OEE,ESS,SCD,and Mo CA were higher than the total scores at baseline(T0)one week after the end of the intervention in the test group(T1)(P < 0.05);the total scores of OEE,ESS,SCD,and Mo CA were higher than the total scores at baseline(T0)one week after the end of the intervention in the control group(T1)(P < 0.05).Conclusions:(1)This study constructs a goal-setting theory-based exercise intervention program for older adults with cognitive impairment in the community based on theory and evidence.(2)The exercise intervention program based on goal-setting theory can significantly improve physical activity level,compliance,exercise selfefficacy,and cognitive function of older adults with cognitive impairment in the community and ensure the safety of older adults with cognitive impairment in the community.3 figures,15 tables,112 references.