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Effects of a wearable-assisted walking program on longitudinal trajectories of cognitive function and loneliness in older adults: a randomized controlled trial
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DOI：10.1186/s12877-026-08109-y.png)
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Abstract
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Cognitive decline and loneliness are important challenges in later life. Although walking-based interventions may support cognitive and psychosocial health, less is known about how these outcomes change over time or whether baseline physical capacity explains individual differences in their trajectories. This study examined the parallel growth trajectories of cognitive function and loneliness during a 12-week wearable-assisted walking intervention and evaluated whether baseline muscle health and functional mobility were associated with these changes. A 12-week, two-arm randomized controlled trial was conducted with 120 community-dwelling older adults. Participants were randomly assigned to a wearable-assisted walking group (n = 60) or a control group without structured walking intervention (n = 60). Cognitive function, assessed using the Montreal Cognitive Assessment, and loneliness, assessed using the 8-item UCLA Loneliness Scale, were measured at baseline, week 4, week 8, and week 12. Baseline appendicular skeletal muscle mass index and timed up-and-go performance were selected a priori as physical predictors. Data were analyzed using conditional parallel-process latent growth curve modeling adjusted for age and education. Compared with the control group, the wearable-assisted walking intervention was associated with a significantly steeper increase in cognitive function (slope estimate = 0.39, p < .001) and a significantly steeper decrease in loneliness (slope estimate = − 1.28, p < .001). The covariance between cognitive and loneliness slopes was not statistically significant, suggesting partially distinct longitudinal trajectories. Poorer baseline functional mobility was associated with higher initial loneliness (intercept estimate = 0.55, p = .001). Lower baseline appendicular skeletal muscle mass index was associated with a greater reduction in loneliness over time (slope estimate = 0.52, p = .010). A 12-week wearable-assisted walking intervention was associated with more favorable longitudinal trajectories of cognitive function and loneliness than the control condition among community-dwelling older adults. Baseline functional mobility was associated with initial loneliness, whereas lower appendicular muscle mass was associated with greater psychosocial improvement. Wearable-assisted walking may represent an accessible strategy for promoting cognitive and psychological well-being in older adults. ClinicalTrials.gov, NCT07650292. Registered 16/06/2026. Retrospectively registered.
Keywords:
Latent growth curve modeling
Cognitive function
Loneliness
Wearable device
Walking intervention
Sarcopenia
Older adults
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