Chair Exercise and Intergenerational Activities in Older Adults With Physio-Cognitive Decline Syndrome (PCDS)

The Role of Chair Exercise and Intergenerational Activities in Older Adults With Physico-Cognitive Decline Syndrome: An Investigation of Frailty and Serum Mature Brain-Dervied Neurotrophic Factor Level

The goal of this clinical trial is to investigate the effects of chair exercise followed by intergenerational activity in frailty syndrome and changes in serum mBDN levels among older adults with Physio-Cognitive Decline Syndrome (PCDS), as a novel approach integrating physical and social intervention with biomolecular assessments

In older adults with PCDS

1. Does A 16-week program of chair exercise followed by intergenerational activity improve handgrip strength (HGS), gait speed, MoCA-Ina scores, and health-related quality of life?
2. Does a 16-week program of chair exercise followed by an intergenerational activity increase serum mBDNF level?
3. Are serum mBDNF levels associated with MoCA-Ina scores, gait speed, and handgrip strength?

Intervention Group

Participants will undergo a 12-week structured chair exercise program, conducted with a trained exercise instructor and supervised by a physician for vital sign monitoring during each session. The frequency of sessions will increase progressively:

• Weeks 1-2: once weekly
• Weeks 3-6: twice weekly
• Week 7-12: three times weekly

Additional activities include (intervention and control group):

• Weeks 1 and 11: teleconference session on nutrition and physical exercise supported by electronic flyers (e-flyers).
• Weeks 3, 5, 7, 11, and 13: distribution of e-flyers on elderly nutrition and the muscle-brain axis.

Additional Activity (intervention group)

- Weeks 13-16: intergenerational activities at an orphanage with children aged >5 years

Assessments (intervention and control group):

• Week 1: serum mBDNF and HbA1c measurement
• Week 12 and 16: physical assessments (body weight, height, handgrip strength, gait speed, MoCA-Ina, and IADL) and serum mBDNF measurement.

Control Group:

The participant will receive general health education on performing physical exercise 1-3 times per week throughout week 1-16

Study Overview

• Status: Completed
• Conditions: Cognitive Frailty
• Intervention / Treatment: Behavioral: Intervention 1

Detailed Description

Population aging in Indonesia has led to a growing proportion of older adults experiencing functional and cognitive decline. Physio-cognitive decline syndrome (PCDS), defined as the coexistence of reduced physical performance (such as slow gait speed or weak handgrip strength) and mild cognitive impairment without disability or dementia, is considered an early and reversible stage that increases the risk of frailty, disability, and poor quality of life.

Chair exercise provides a safe and feasible intervention for older adults, with proven benefits in muscle strength, balance, and neurocognitive function, partly mediated through increased levels of brain-derived neurotrophic factor (BDNF). In parallel, an intergenerational activity involving direct interaction between older and younger individuals has shown promise in improving psychosocial well-being and cognitive outcomes.

This study integrates chair exercise with intergenerational activities to target the multidimensional nature of PCDS. Outcomes will focus on frailty status and changes in serum mature brain-derived neurotrophic factor (mBDNF) to establish a multimodal, culturally adapted strategy to support healthy aging in Indonesian older adults.

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Indonesia
  • Jakarta Special Capital Region
    • Jakarta, Jakarta Special Capital Region, Indonesia
      • Catholic Church of St. Anthony of Padua, Bidaracina, GKI Depok, Catholic Church of St. Anna, Catholic Chrusch St. Aloysius Gonzaga

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

• Aged 60-75 years
• Meet diagnostic criteria for physio-cognitive decline syndrome (PCDS): gait speed <1.0 m/s and/or hand grip strength <28 kg (men) or <18 kg (women), and MoCA-Ina score 22-26
• Instrumental Activities of Daily Living (IADL) score >5
• Able to understand and follow instructions adequately
• Willing to participate and provide written informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Arm; Nutritional education + 12 weeks structured chair-based exercise (PEROSI protocol, progressive frequency from 1 to 3 sessions/week, 60 minutes/session, supervised online) followed sequentially by 4 weeks SHP-based intergenerational activities (8 sessions, 2x/week, 45 minutes/session, paired 1:1 elderly-child using AMIR educational materials at selected orphanages).	Behavioral: Intervention 1; Nutritional education + 12 weeks structured chair-based exercise (PEROSI protocol, progressive frequency from 1 to 3 sessions/week, 60 minutes/session, supervised online) followed sequentially by 4 weeks SHP-based intergenerational activities (8 sessions, 2x/week, 45 minutes/session, paired 1:1 elderly-child using AMIR educational materials at selected orphanages).
No Intervention: Control Arm; Nutritional education only (2 personalized dietitian tele-conferences at weeks 1 and 11; 5 educational e-flyers at weeks 3, 5, 7, 13, and 15)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frailty Syndrome Status	• Change in frailty syndrome status (assessed using Cardiovascular Health Study criteria: score 0 robust, 1-2 pre-frail, ≥3 frail) from baseline to week 16.	From enrollment to the end of treatment at 12 weeks
serum mature brain-derived neurotrophic factor (mBDNF)	Change in serum mature brain-derived neurotrophic factor (mBDNF) levels (measured by ELISA) from baseline to week 16.	from baseline to week 16

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hand grip strength	Change in hand grip strength (in kilogram; dominant hand, best of 3 trials using hand dynamometer) from baseline to week 16.	from baseline to week 16
Gait Speed Test	Change in gait speed (m/s; average of 2 trials over 6-meter walk test) from baseline to week 16.	baseline to week 16
Cognitive Function	Change in cognitive function (MoCA-Ina total score, range 0-30)	from baseline to week 16
health-related quality of life (SF-12 questionnaire)	Change in health-related quality of life (SF-12 questionnaire)	from baseline to week 16
serum mBDNF levels	Correlations between changes in serum mBDNF levels and changes in MoCA-Ina score, hand grip strength, and gait speed.	baseline to week 16

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adherence to exercise sessions	Adherence to exercise sessions	from baseline to week 12
Intergenerational activities	Adherence to intergenerational activities (attendance logs)	from weeks 13 to weeks 16
Physical Activity Scale for the Elderly, PASE	Physical activity level (Physical Activity Scale for the Elderly, PASE) is an easily administered and scored instrument that measures the level of physical activity in individuals aged 65 years and older. PASE Scored may range from zero to 400 or more	from baseline to week 16
Depressive Symptoms	The Geriatric Depression Scale-15 (GDS-15) is a widely used, self-report screening tool designed identify depression in older adults. The 15-item version (GDS-15) is common, and Patients answer "yes" or "no" to 15 questions regarding how they felt over the past week. Interpretation: 0 - 4: Normal; 5 - 10: Mild to moderate depression; 11 - 15: Severe Depression	from baseline to week 16
Loneliness	The questionnaire of De Jong Gierveld Loneliness Scale, Indonesian version is a concise tool designed to capture both emotional and social dimensions of loneliness. The total loneliness score can be categorized into four levels: not lonely (Score 0, 1 or 2), moderate lonely (score 3 through 8), severe lonely (score 9 or 10), and very severe lonely (score 11)	From baseline to weeks 16
Quality of Life Additional Domains	Questionnaire of Quality of life additional domains (EQ-5D-5L) is a brief, multiattribute, generic, health status measure composed 5 questions with likert response options (descriptive system). EQ-5D-5L index scores range from -0.59 to 1, where 1 is the best possible health state	from baseline to week 16
Charison Comorbidity Index (CCI)	The questionnaire of the Charlson Comorbidity Index (CCI) predicts the mortality for a patient who may have a range of concurrent conditions (comorbidities), such as heart disease, AIDS, or cancer (considering a total of 17 categories). Based on the CCI scores, the severity of comorbidity was categorized into three grades: mild, with CCI scores of 1-2, moderate, with CCI scores of 3-4, and severe, with CCI scores ≥5	baseline

Collaborators and Investigators

• Sponsor: Atma Jaya Catholic University of Indonesia

Study record dates

Study Major Dates

• Study Start (Actual): September 24, 2025
• Primary Completion (Actual): March 16, 2026
• Study Completion (Actual): March 16, 2026

Study Registration Dates

• First Submitted: January 2, 2026
• First Submitted That Met QC Criteria: January 2, 2026
• First Posted (Actual): January 13, 2026

Study Record Updates

• Last Update Posted (Actual): May 4, 2026
• Last Update Submitted That Met QC Criteria: April 28, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 25-06-0948

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No