The CON group did not have any intervention but usual care.

The Monreal Cognitive Assessment, known as MoCA-T, is a questionnaire comprising 11 topics with a maximum score of 30 points. It serves as a comprehensive tool for assessing various aspects of cognitive intelligence in various areas, including management, naming, concentration, language use, and abstract thinking.

The Mini-Mental State Examination Thai (MMSE-T) is a preliminary brain condition test that comprises 11 topics with a maximum score of 30 points. This basic brain state test is utilized to assess various aspects of cognition, including awareness of surrounding conditions, perception of time, spatial orientation, concentration and calculation, language use, and repetition.

The Trail Making Test B Thai modified (TMT-B) is a subtest in the Halstead-Reitan Neuropsychological test, adapted into Thai. The criteria for normalcy is set at no more than 89 seconds for individuals aged 60 years and over. The test includes numbers 1-13 and month abbreviations in Thai (Jan. - Dec.), totaling 25 characters, which consist of numbers and/or letters. They are arranged in a distributed manner, and when connecting lines are drawn, they will not intersect. The TMT-B serves as an assessment of cognitive ability, focusing on concentration and management.

The participants were instructed to sit on a chair and wear a nose clip. The researcher provided them with a detailed set of instructions to ensure they performed the maneuver correctly according to guidelines of the American Thoracic Society (ATS). Prior to demonstrating forced inspiration and expiration, the participants were asked to perform three cycles of slow normal breathing as part of the FVC maneuver. FEV1 (L) will be reported in liter (L).

The participants were instructed to sit on a chair and wear a nose clip. The researcher provided them with a detailed set of instructions to ensure they performed the maneuver correctly according to guidelines of the American Thoracic Society (ATS). Prior to demonstrating forced inspiration and expiration, the participants were asked to perform three cycles of slow normal breathing as part of the FVC maneuver. FEV1/FVC will be reported in percent (%).

The participants were instructed to sit on a chair and wear a nose clip. The researcher provided them with a detailed set of instructions to ensure they performed the maneuver correctly according to guidelines of the American Thoracic Society (ATS). During the MVV maneuver, participants were instructed to demonstrate in rapid and forceful inhalation and exhalation for a duration of 10 seconds. MVV will be reported in liter per minute (L/min).

Respiratory muscle strength was evaluated by measuring Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) in centimeters of water (cmH2O). The participants were seated and utilized a portable handheld mouth pressure meter (MicroRPM), along with a nose clip. To assess MIP, participants were instructed to exhale until they emptied their lungs at the point of functional residual capacity (FRC). Participants held the device to their mouth and forcefully inhaled for 1-2 seconds. For the measurement of MEP, participants were directed to inhale until their lungs were completely filled with air, starting from the total lung capacity (TLC) point. Participants were asked to maintain the device on their mouth and forcefully exhaled for 1-2 seconds.

The Chair Sit and Reach Test is used to assess the flexibility of the back and legs. Participants sit in chairs with their feet touching the floor and positioned on the edge of the chair. The non-dominant leg should have the sole of the foot touching the floor, while the dominant foot is extended. Next, fold at the hips and reach with the middle finger of the hand on the same side as the outstretched leg to touch the middle finger to the outstretched foot. The researcher then measures the distance between the fingers and toes. If they touch each other, it indicates a distance equal to zero. Then, participants switch sides.

The Back Scratch test is conducted to assess shoulder flexibility. Participants perform stretches targeting their shoulders, shoulder blades, chest, and arms, then stand upright. They lift their right arm above the shoulder, bend the elbow down behind the back in a palm-down position, with palms and fingers resting flat on the back. Participants press down as far as possible. Simultaneously, they raise their left arm backward in an inward twisting motion, bending the elbow and folding it up so that the backs of their hands rest against the back of their body. They lift their hands as high as possible, trying to bring the right and left hands together as much as possible. After holding for about 3 seconds, participants return to the starting position with arms released at their sides. The test is repeated two more times on each side. The assessment measures the distance between the tip of the middle finger of the upper hand and the tip of the radial styloid process of the lower hand.

The Time Up and Go test is a mobility and balance assessment. Participants begin by sitting in chairs with the soles of both feet touching the floor. At the start of the test, participants stand up, walk towards a target 3 meters from the starting point, circumnavigate the target, and then return to their original seat. The researcher measures the time from the starting point until the participant returns to a seated position.

The Chair Stand test involves the use of a chair without armrests. The chair should be tall enough for participants to sit with their feet touching the floor. Initially, participants are asked to sit in the chairs. When the test begins, they stand up with both hands holding the shoulder blades in a crossed position. A timer is then set for 30 seconds to count how many times participants can sit and stand within that duration.

The Arm Curl test involves participants holding a steel ball on their dominant side, weighing 5 pounds for women and 8 pounds for men. Participants lift the steel ball with their arms fully bent and stretch their arms as far as possible, counting as one repetition. Participants perform as many repetitions as possible within a 30-second time frame.

The 2-Minute Step Test is an assessment of activity ability and endurance of the lower limb muscles. The researchers determined that the knee lift height for each elderly person would be at the midpoint between the knee and the upper edge of the hip bone. When the researcher gave the "start" command to the participants to raise their legs in place as many times as possible within 2 minutes, the researchers counted the number of leg lifts when the knees reached the designated point.

The 6-Minute Walk Test is a sub-maximal exercise test used to assess the ability to perform activities for extended periods. Participants are instructed by the researcher to walk at their comfortable speed for 6 minutes, covering a minimum distance of 15 meters before turning around. The researcher records the distance walked within the 6-minute timeframe.

Draw 15 milliliters of blood to analyze blood biochemistry, including fasting plasma glucose (FPG), accumulated blood sugar level (HbA1c), insulin resistance (Homeostasis Model Assessment; HOMA-IR), cholesterol (Cholesterol), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (Triglyceride), BDNF (Brain-Derived Neurotrophic Factor), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α).