4Active Intervention for Promoting Physical Activity and Cognitive Flexibility Among Older Adults

Physical activity is essential to delaying cognitive decline and preventing cognitive impairment in older adults. We designed and implemented two-level 4Active intervention for older adults living in retirement communities. This study aimed to examine the effectiveness of the 4Active intervention in increasing physical activity and cognitive function in older adults. Fifty-eight eligible older adults with a mean age of 83.83 years (76.3% females) living in two retirement communities voluntarily participated in this study. Forty subjects participated in the two-level 4Active intervention for 12 weeks and 18 subjects were in the control group. Each participant was pre-and posted tested on physical activity (PA) and cognitive flexibility. Data were analyzed by means of descriptive statistics, independent sample t-tests, and Analysis of Covariance (ANCOVA) with repeated measures. ANCOVA with repeated measures indicated that the intervention group had overall higher levels of the total PA and the moderate PA than the control group (F = 11.838, p = 0.001, η² = 0.180; F = 11.068, p = 0.002, η² = 0.170). For light PA, ANCOVA revealed a significant interaction effect between time and group (F = 8.477, p = 0.005, η² = 0.136). The intervention group showed increases in light PA (walking) with a medium effect size (Cohen’s d = 0.538) over time, while the control group decreased light PA from baseline to the post-test. Regarding the results of cognitive flexibility, the ANCOVA with repeated measures revealed that intervention group had overall higher levels of cognitive function compared to the control group (F = 7.88, p = 0.007, η² = 0.129). Both groups showed significant increases in cognitive flexibility over time (F = 6.68, p = 0.013, η² = 0.112), but the intervention group had a smaller change in cognitive flexibility over time compared to the control group (F = 6.75, p = 0.012, η² = 0.113). Engaging in technology-enhanced multicomponent exercises is an effective approach to contributing to physically active and cognitively competent aging.