Mediterranean Diet Interventions for Eating Behavior and Cognitive Performance Among Older Adults in the Community

Study Overview
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Brief Summary
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The object is to investigate the effects of a modified Mediterranean diet learning intervention program with a Mini-flipped game strategy on dietary behavior and cognitive function of elderly people in the community. The six communities were randomly assigned to the experimental group and the control group. The intervention group will last for 8 weeks. An eight-week Mediterranean diet learning program applying mini-flipped game-based learning strategies could improve dietary behavior and global cognitive function among elderly people living in the general community.

Detailed Description
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Background：The world is facing an aging population, with an increase in the number of people with mild cognitive impairment and dementia, creating a huge burden of medical costs for individuals, families, and society. Previous studies have shown that the Mediterranean Diet delays cognitive decline, but older adults are less likely to follow the Mediterranean Diet and have less knowledge about the risk of dementia and protective factors of the diet. This study will integrate the Asian version of the Mediterranean Diet Pyramid and local ingredients from Taiwan to design a nutritional health education and game intervention for the Mediterranean Diet. Purposes：To investigate the effectiveness of developing a Mini-flipped Game-based Learning strategy to promote dietary behavior and cognitive function in the community elderly with a modified diet learning intervention. Methods：This study was a cluster-randomized controlled trial. The six communities were randomly assigned to the experimental group and the control group.The intervention group completed an eight-week, mini-flipped, game-based learning program reinforcing compliance with the Mediterranean diet, consisting of one 40-minute session per week. The control group members maintained their usual daily diet and were given a booklet on nutrition and health. All participants will be assessed at baseline(0 weeks) and post-test(8 weeks).

Official Title
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Develop the Mini-flipped Game-based Learning Strategies in Modified Mediterranean Diet Interventions for Eating Behavior and Cognitive Performance Among Older Adults in the Community

Conditions
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Healthy

Intervention / Treatment
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* Behavioral: Mini-flipped Game-based Learning
* Behavioral: Balanced diet


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 65 years and older No visual, hearing, or mental impairment, and could speak Mandarin. Are willing to participate in the study and fill out the volunteer consent form. Exclusion Criteria: Diagnosis of cognitive dysfunction, brain injury with loss of consciousness for more than 30 minutes, or other central nervous system disorders. The presence of impaired sensory problems. Severe illnesses such as heart, liver, and lung failure, end-stage renal disease, total paralysis, terminal cancer or chemotherapy, and a diagnosis of mental illness

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mini-flipped Game-based Learning<br>group diet education, an interactive food card game, and guidance on the Mediterranean diet once a week for 40 minutes. lasts for 8 weeks | Behavioral: Mini-flipped Game-based Learning<br>* The intervention was 8 weeks, forty minutes adjusted Mediterranean diet learning plan once a week, which includes the 20 minutes for the Mediterranean food table game, and the 20 minutes for the Mediterranean diet nutrition course. The topic of the course includes the relationship between Mediterranean diet and dementia, knowledge of Mediterranean diet, how to integrate local food ingredients into the Mediterranean diet, etc.<br>|
| Placebo Comparator: Balanced diet<br>given a leaflet on balanced diet and nutrition among the elderly lasts for 8 weeks | Behavioral: Balanced diet<br>* Given a balanced diet nutrition health education manual for the aged.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mediterranean Diet Score | To measure the Mediterranean dietary behavior | Change from baseline outcome measure at 8th week (post-test) | 
| Nutrition Knowledge test for the Elderly | To measure the nutrition knowledge | Change from baseline outcome measure at 8th week (post-test) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Montreal Cognitive Assessment score | To measure the objective cognitive function | Change from baseline outcome measure at 8th week (post-test) | 
| Cognitive Failures Questionnaire score | To measure the subjective cognitive function | Change from baseline outcome measure at 8th week (post-test) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mini-flipped Game-based Learning, Mediterranean Diet, Eating Behavior, Cognitive Performance