Effect of wearables with behavioral prompts on physical and cognitive outcomes in community-dwelling older adults: preliminary results of a pilot randomized controlled trial.

INTRODUCTION: The global rise in life expectancy has driven research into aging-related vulnerabilities, particularly cognitive frailty. Physical activity interventions have been identified as a protective factor, and technology, such as wearable devices, may enhance engagement. This pilot RCT explores mobile phone applications and smartwatch-based interventions to promote physical activity and improve cognitive health in older adults. METHODS: This single-blind pilot RCT enrolled 53 adults aged 60-85 in Singapore through convenience sampling. Participants were randomized (1:1) into an intervention group receiving daily activity prompts or a control group with no prompts. Primary outcomes like physical activity levels, neurocognitive scores, and physical frailty scores were assessed at baseline, 3 months, and 6 months. We hypothesize that the intervention group will demonstrate higher physical activity levels, leading to improved cognitive and physical outcomes at end point. RESULTS: This study found no significant differences in physical activity levels between the intervention and control groups. However, the intervention group showed significant improvements in balance and fall risk, with a greater reduction in Timed Up and Go scores from T1 to T2 (p = .026). For neurocognitive outcomes, the intervention group demonstrated significant improvement in the Colour Trail Test over time, whereas the control group's performance declined from T1 to T2 (p = .044). At T3, the intervention group experienced a greater decline in performance in the Digit Span Backwards test from T1 to T3 compared to the control group (p = .014). DISCUSSION: This study highlights the benefits of digital physical activity interventions for the physical and cognitive health of older adults. However, the findings underscore the complexities of behaviour change, suggesting that adherence significantly influences outcomes. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT04692974.