Objective: To evaluate the feasibility and effect of nurse-led cognitive-motor dual-task training based on mobile health technology in people with cognitive frailty and investigate its potential for transforming practice in this population.
Methods: From September 2021 to May 2022, a total of 74 older adults with cognitive frailty were screened at a Cognitive Memory Clinic of a tertiary hospital in Beijing. The control and intervention groups received health education related to cognitive frailty; additionally the intervention group received cognitive-motor dual-task training based on mobile health technology at home for 12 weeks, three times a week. At baseline (T0), post-intervention (T1) and one-year follow-up (T2), Montreal Cognitive Assessment-Peking version (MoCA-P), Fried Frailty phenotype (FP), Short Physical Performance Battery (SPPB), and Modified Fall Efficacy Scale (MFES) were employed to evaluate cognitive function, frailty, physical function, and fear of falling, and to assess the impact of cognitive-motor dual-task training on these measures.
Results: The data collected for 65 out of 74 participants enrolled for the study was completed after 12 weeks intervention, including 34 participants in the control group and 31 participants in the intervention group. During the intervention, the majority (83.8 %) of the participants in the intervention group were able to complete the recommended intervention dose for 12 weeks under the guidance of nurses and the presence of caregivers. At the end of the 12-week intervention, the intervention group showed statistically significant improvements compared to the control in scores of MoCA-P (t=4.017, p<0.001), FP (t=3.739, p<0.001), MFES (t=4.283, p<0.001) and SPPB (t=3.548, p<0.001). At after one-year follow-up, the scores of MoCA-P (t=3.237, p<0.05), FP(t=3.725, p<0.001), and MFES (t=4.473, p<0.001) in the two groups remained statistically significant. Cognition, frailty and fear of falling were significantly affected by intergroup effects (Pgroup<0.05), time effects (Ptime<0.05) and interaction effects (Pgroup*time<0.001).
Conclusions: The cognitive-motor dual-task training program based on mobile health technology developed by nurses exhibited high feasibility and acceptability in older people with cognitive frailty. The intervention was found to significantly improve cognitive function, frailty, physical function, and fear of falling in older individuals with cognitive frailty, and showed a specific long-term maintenance effect. This study provides evidence for the promotion and application of mobile health technology, and serves as a practical basis for home health intervention for older individuals in the post-pandemic era.
Keywords: Cognitive frailty; Dual-task training; Mobile health; Nurse-led.
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