Digital Technology for Active and Healthy Ageing in Taiwan

May 15, 2026 updated by: Ta-wei Guu, China Medical University Hospital

Healthy Taiwan Cultivation Plan: Building an Active-ageing Lifestyle in Rural Taiwan Through Integrating Novel Healthcare Technology - From Mitigating Digital and Health Literacy Gap, Establishing a Mobile Interactive Pro-active-ageing Information Platform, to Exploring Multi-dimensional Digital Biomarkers of Ageing

Taiwan is entering a super-aged society in 2025, with more than 20% of the population aged 65 years or older. This rapid demographic shift, combined with increasing rates of chronic diseases, frailty, and dementia, has created growing challenges for healthcare and caregiving systems. Yunlin County, particularly its coastal region, has been one of Taiwan's earliest super-aged areas, showing higher rates of diabetes (10.5%), hypertension (28%), hyperlipidemia (26%), dementia (8%), and depression (12%) compared with national averages. Lifestyle factors such as tobacco (30%), betel nut (8%), and alcohol (15%) use are also more prevalent among local residents.

From 2022 to 2024, health screenings at CMU Beigang Hospital revealed a 36.1% abnormality rate among 12,222 visits, while another 5,965 assessments from the county's ICOPE program showed similarly high rates. Many older adults, particularly retired agricultural and fishing workers, experience sedentary lifestyles and polypharmacy-related risks, which worsen frailty, insomnia, depression, and cognitive decline. Low general and digital health literacy further limits their ability to adopt preventive behaviors, forming a vicious cycle between poor health and aging.

To address these challenges, the Ministry of Health and Welfare launched the "Healthy Taiwan Cultivation Plan." In alignment with this initiative, this project-led by CMU Beigang Hospital in collaboration with the National Health Research Institutes-aims to develop a wearable- and mobile-based health promotion model for rural older adults. The study will integrate research-grade actigraphy (Geneactiv), a mobile health platform ("iMED"), and the in-bed sensor iCue to monitor behavior, promote active aging, and enhance health and digital literacy. Ultimately, this project seeks to establish Taiwan's first integrated digital aging database and identify digital biomarkers for predicting cognitive and functional decline in older adults.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This prospective observational cohort study aims to develop and assess a wearable and mobile health-based research framework to characterize health status, sleep, circadian rhythm, physical activity, digital literacy, and cognitive-related biomarkers among older adults living in rural Taiwan. The study focuses on Yunlin County, one of Taiwan's early super-aged regions, where chronic diseases, frailty, and dementia-related health needs are highly prevalent.

The study uses research-grade wearable and digital tools, including a GeneActiv actigraphy device, an AI-supported mobile health platform, and a smart in-bed sensor, to collect data on physical activity, sleep patterns, and related physiological parameters. The Aging Well Taiwan framework and the World Health Organization's Integrated Care for Older People framework will also be used to support standardized assessment of older adults' health status, health literacy, digital literacy, and functional needs.

Phase I, conducted from 2025 to 2026, will establish baseline data and assess the feasibility, usability, and acceptability of wearable and mobile health tools in community and outpatient settings. Participants will wear GeneActiv devices for at least two weeks, complete ICOPE assessments, and provide blood samples for dementia-related biomarkers, including total tau, phosphorylated tau 181, phosphorylated tau 217, amyloid beta 1-40, amyloid beta 1-42, neurofilament light chain, and apolipoprotein E genotyping. Validated questionnaires will be used to assess health literacy, digital literacy, lifestyle factors, and related clinical characteristics.

Phase II, conducted from 2027 to 2029, will extend the observational follow-up by integrating mobile health platform data with wearable and sensor-derived measures. Participants will be followed every three months to assess changes in activity, sleep, medication use, mental well-being, and behavioral outcomes. Quantitative data will be analyzed using GGIR and R software, while qualitative interviews will explore usability, user satisfaction, and experiences related to technology use.

This study will establish an integrated digital aging research database in Taiwan that combines wearable, behavioral, clinical, and biological data. Through collaboration with international partners such as the RADAR-AD consortium, the project aims to identify digital phenotypes and biomarkers associated with cognitive and functional decline. Ultimately, the study aims to inform a sustainable, evidence-based, and technology-supported model for promoting healthy aging and improving well-being among older adults in rural communities.

Study Type

Observational

Enrollment (Estimated)

140

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • United Kingdom
    • Alabama
      • London, Alabama, United Kingdom, WC1N 2AN
        • Recruiting
        • China Medical University Beigang Hospital
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study population includes community-dwelling and outpatient older adults who are recruited through clinical services, community outreach, and research-related activities at China Medical University Beigang Hospital. Eligible participants are older adults who are willing to participate in the study and able to complete clinical assessments, cognitive evaluation, blood sample collection, and wearable device monitoring.

Description

Inclusion Criteria:

  1. Currently living or receiving care in a stable environment for at least four weeks prior to enrollment:

    • For community-based participants: must have resided at the same address for ≥4 weeks.
    • For day-care participants: must have attended activities at the same dementia or elderly day-care center for ≥4 weeks.
  2. Able and willing to participate in the study procedures.

  3. Informed consent must be obtained before participation.

    • If the participant's cognitive function has declined to a level that prevents self-consent, written consent will be obtained from a legally authorized representative or primary caregiver.

Exclusion Criteria:

  1. Unstable physical or psychological condition that makes participation unsafe, as determined by a clinical investigator - e.g., acute delirium or current respiratory infection (including COVID-19).
  2. Any known allergy or skin sensitivity to the materials used in the Geneactiv actigraphy device or iCue sensor pad.
  3. Any other medical, neurological, or behavioral condition deemed unsuitable for participation by the study physician.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Health Promotion through Wearable and Mobile Technology

Participants will join a community-based health program integrating wearables, mobile health platforms, and structured education to promote active lifestyles, enhance health literacy, and collect longitudinal data in older adults in rural Taiwan.

Participants will:

  1. Wear a research-grade wrist actigraphy device (GeneActiv) to record activity, sleep, and light exposure for ≥2 weeks.
  2. Use the iMED mobile app (NHRI, Taiwan) for feedback, health education, and medication tracking.
  3. For participants with limited mobility, use an under-mattress iCue sensor to monitor respiration and movement.
  4. Attend Aging Well Taiwan sessions based on the WHO ICOPE framework.
  5. Provide baseline and follow-up blood samples for dementia-related biomarkers (Tau, Aβ, NfL) and APOE genotyping.
Device: Geneactiv
Participants will wear a research-grade actigraphy device (Geneactiv original, developed by Activinsights UK) on the non-dominant wrist for at least two consecutive weeks to continuously record physical activity, sleep-wake patterns, and light exposure. The visualised results will be presented to the participants to motivate their behavioural change.
Behavioral: iMED Mobile Health Platform
Participants will use the "iMED" mobile application developed by the National Health Research Institutes in Taiwan (https://www.nhri.imed-health.com/). The platform provides personalized health education, medication reminders, AI-driven feedback on wearable data, and links to Taiwan's National Health Insurance health records.
Device: iCue
A non-invasive smart mat (iCue) placed under the mattress continuously monitors respiration rate, movement, and sleep parameters in participants with limited mobility.
Behavioral: Aging Well Taiwan
Participants will attend a community-based educational course adapted from Singapore's "Aging Well" framework, covering physical activity, diet, cognitive health, and digital literacy. The program follows the WHO Integrated Care for Older People (ICOPE) model and supports active aging and social participation.
Biological: Blood Biomarker Sampling
Participants will provide venous blood samples at baseline and follow-up visits for analysis of dementia-related biomarkers, including total Tau, phosphorylated Tau 181 (pT181), phosphorylated Tau 217 (pT217), amyloid beta 1-40 (Aβ40), amyloid beta 1-42 (Aβ42), and neurofilament light chain (NfL), as well as apolipoprotein E (APOE) genotyping.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Activity-Sleep Pattern Regularity
Time Frame: Baseline to 36 months.

Mean daily activity counts, sleep-wake cycles, and circadian rhythm stability will be assessed using Geneactiv and iCue in-bed sensors.

Variables include total activity counts, sleep duration, sleep efficiency, wake after sleep onset (WASO), daytime napping, light exposure amount and timing, M5/L5 (five hours of highest/lowest activity), mean sleep midpoint (MSA), intra-daily variability (IV), inter-daily stability (IS), and Sleep Regularity Index (SRI).

Data will be analyzed using the open-source GGIR algorithm and R software to evaluate individual day-night rhythm stability and longitudinal changes.
Baseline to 36 months.
Integrated Care for Older People (ICOPE) Function Assessment
Time Frame: Baseline to 36 months.
As assessed using the WHO Integrated Care for Older People (ICOPE) screening tool, covering six domains: cognition, mobility, nutrition, vision, hearing, and mood. Scores are classified as "declined" or "maintained" function for each domain. Higher functional integrity across domains indicates better overall health status.
Baseline to 36 months.
Qualitative Evaluation of Feasibility and User Experience
Time Frame: Baseline to 36 months (post-intervention qualitative evaluation).

Semi-structured interviews and focus groups will be conducted with participants and caregivers to explore usability, satisfaction, and perceived benefits of the Geneactiv wearable, iCue in-bed sensor, and iMED mobile platform.

Interview data will be analyzed thematically to identify facilitators, barriers, and behavioral impacts related to long-term use.
Baseline to 36 months (post-intervention qualitative evaluation).
Biomarkers for Cognitive and Functional Decline
Time Frame: Two time points - baseline (before intervention) and end of study (month 36).

Venous blood samples (10 mL) will be collected to measure total Tau, phosphorylated Tau 181 (pT181), phosphorylated Tau 217 (pT217), amyloid beta 1-40 (Aβ40), amyloid beta 1-42 (Aβ42), and neurofilament light chain (NfL) using validated immunoassays.

APOE genotyping will be performed once at baseline. These blood-based biomarkers will be correlated with digital device-derived metrics (SRI, IS, IV) and cognitive outcomes to explore their potential as predictors of cognitive decline.
Two time points - baseline (before intervention) and end of study (month 36).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

China Medical University Hospital

Collaborators

Ministry of Health and Welfare, Taiwan

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 22, 2026

Primary Completion (Estimated)

December 31, 2028

Study Completion (Estimated)

December 31, 2029

Study Registration Dates

First Submitted

November 14, 2025

First Submitted That Met QC Criteria

November 14, 2025

First Posted (Actual)

November 18, 2025

Study Record Updates

Last Update Posted (Actual)

May 18, 2026

Last Update Submitted That Met QC Criteria

May 15, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • CMUH114-REC3-134

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

We will decide if the IPD can be shared before the end of the study.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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