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

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

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.