Moderate-Intensity Aerobic Calisthenics for Rural Elderly With Motoric Cognitive Risk Syndrome

A Study on the Application of Moderate-Intensity Aerobic Calisthenics in Rural Elderly With Motoric Cognitive Risk Syndrome

The aging of China's rural population is severe, with both the prevalence and mortality rates of dementia higher in rural areas than in urban areas. Motor Cognitive Risk Syndrome (MCR), as a novel pre-dementia syndrome characterized by both subjective cognitive decline and slow gait, represents a "golden window of opportunity" for the early prevention and treatment of dementia. Currently, there is no specific pharmacological treatment for MCR; non-pharmacological interventions, particularly exercise interventions, are key strategies. Moderate-intensity aerobic calisthenics, which integrates music, dance, and gymnastic elements, is economical, simple, highly engaging, safe, and has demonstrated potential for improving both cognitive and gait function, making it especially suitable for promotion in resource-limited rural settings. However, there is a lack of systematic, theory-guided exercise intervention protocols and effectiveness validation for rural older adults with MCR. Therefore, this study aims to develop and validate a moderate-intensity aerobic calisthenics intervention protocol tailored to this population.

Motor Cognitive Risk Syndrome (MCR), first defined by Verghese et al. in 2013, refers to the coexistence of subjective cognitive decline and slow gait in older adults without dementia or movement disorders, representing a novel pre-dementia syndrome situated between normal aging and dementia. The global prevalence of MCR is 9.0% (range: 2.4%-33.3%) , and the prevalence among Chinese older adults ranges from 4.00% to 13.85% , with higher rates in rural than urban areas-reaching as high as 16.7% in rural Anhui Province. MCR significantly increases the risk of dementia (three-fold) and particularly vascular dementia (12-fold) , and also elevates the incidence of falls, disability, and mortality. Cohort studies have shown that 22.1% of individuals with MCR progress to dementia, 57.5% remain in the MCR state, and 20.3% revert to normal cognition. This reversibility suggests that MCR represents a critical window for the ultra-early prevention and treatment of dementia.

Moderate-intensity aerobic calisthenics, which integrates music, dance, and gymnastic elements, is a form of moderate-intensity aerobic exercise. Evidence indicates that it effectively improves cognitive and physical function in older adults, exerts superior cognitive benefits compared to other exercise types, and reduces loneliness and depressive symptoms. The participation rate in physical exercise among older adults in rural China is only 33.9%-48.29%, limited by objective constraints such as lack of facilities and equipment, and monotonous forms of exercise. Aerobic calisthenics, characterized by its economy, simplicity, high appeal, and safety, is well-suited for promotion in rural areas. However, no studies to date have reported the application effects of this intervention in the MCR population, and thus investigating its intervention value in rural older adults with MCR holds significant research importance.

Inclusion Criteria:

• Age ≥60 years;

  • Meeting the diagnostic criteria for Motor Cognitive Risk Syndrome (MCR);

    • Clear consciousness and ability to communicate clearly;

      • Permanent residents of rural areas in nine prefecture-level cities of Fujian Province (with an annual residence of ≥9 months) and no plan to relocate within the next year; -⑤ Willing to voluntarily participate and sign the informed consent form.

Exclusion Criteria:

• Presence of severe mental disorders, history of stroke, Parkinson's disease, or severe visual/auditory impairments;

  • Physical disability that prevents independent walking;

    • Comorbid severe systemic diseases, such as cardiopulmonary conditions; -④ Regular exercise habits within the past 6 months (≥30 minutes/day, ≥3 days/week) or a long-term history of exercise; -⑤ Current participation in other interventional studies.