A Pilot Historical‐Control Study of Nudge‐Based Semi‐Supervised Resistance Exercise in Older Adults With Mild Cognitive Impairment

ABSTRACT Aims To evaluate the feasibility and preliminary effects of the nudges‐based semi‐supervised resistance exercise program in older adults with mild cognitive impairment (MCI). Design A Pilot Historical‐Control Study. Methods Participants in the intervention group received a 12‐week semi‐supervised resistance exercise with nudges. The historical control group consisted of participants from a prior study by our team who received fully‐supervised resistance training. Propensity score matching was performed to generate matched pairs. The primary outcome was the feasibility, including recruitment rate, retention rate, adherence, labor resource costs and participants' perceptions regarding nudges' usefulness. The secondary outcomes were cognitive function and physical function. Results A total of 30 participants in the intervention group and 33 participants in the historical control group completed the program. The recruitment rate for the intervention group was 47.22%, and the retention rate was 88.24%. In the historical control group, the recruitment rate was 59.02%, and the retention rate was 91.67%. Following 1:1 propensity score matching, the adherence rates for the intervention and control groups were 96.59% and 91.85%, respectively, with no significant difference observed ( Z = 1.309, p = 0.191). The intervention group required 15.25 healthcare professional labor hours (344.65 RMB), lower than the control group (24 h; 542.4 RMB). Most nudges were assessed as beneficial; however, certain ones were deemed ineffective, and some that initially showed promise diminished impacts over time. Both groups exhibited significant improvements in cognitive and physical functions from pre‐to post‐intervention, with no significant differences between the groups ( p > 0.05). Conclusion The semi‐supervised resistance exercise program with nudges is a viable alternative compared to fully‐supervised mode. Large‐scale randomized controlled trials should be conducted to validate these findings.