{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:22:22Z","timestamp":1787444542055,"version":"build-2736575974"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001352","name":"National University of Singapore","doi-asserted-by":"publisher","award":["A-8000227-01-00"],"award-info":[{"award-number":["A-8000227-01-00"]}],"id":[{"id":"10.13039\/501100001352","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus (T2DM) is a major modifiable risk factor for accelerated brain ageing, cognitive decline, and dementia. However, sustainable lifestyle interventions targeting cognitive health in at-risk older adult populations remain limited. This mixed-methods study evaluated the effects of a 12-week technology-blended Intensive Aerobic and Resistance Exercise Program (IAREP) on cognitive risk and related health outcomes among middle-aged and older adults with T2DM in a primary care setting in Singapore.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were recruited from a community polyclinic and allocated to either the intervention or usual care group. The intervention integrated face-to-face, Zoom-based, and video-recorded home exercise sessions to support accessibility and adherence. Quantitative outcomes included cognitive impairment (CI) risk, physical function, metabolic and inflammatory markers, physical activity, and self-care maintenance. Qualitative focus group discussions (FGDs) explored participant experiences following program completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-three participants completed the study (mean age 66.7\u2009years). Compared with usual care, the intervention group demonstrated significant reductions in predicted risk of CI (F(1,51)\u2009=\u20094.9, p\u2009=\u2009.031, \u03b7\u00b2p\u2009=\u20090.088), improvements in physical function (F(1,51)\u2009=\u200910.6, p\u2009=\u2009.002, \u03b7\u00b2p\u2009=\u20090.172), and higher physical activity levels (F(1,51)\u2009=\u20098.3, p\u2009=\u2009.006, \u03b7\u00b2p\u2009=\u20090.140). Self-care maintenance also improved significantly (F(1,51)\u2009=\u20094.5, p\u2009=\u2009.040, \u03b7\u00b2p\u2009=\u20090.081). Adherence was high (88.9%). Qualitative findings highlighted enhanced motivation, social connectedness, and perceived cognitive and physical well-being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings support technology-blended exercise might be a feasible and scalable strategy for cognitive risk reduction and brain health promotion among middle-aged and older adults with T2DM, with potential translational relevance for dementia prevention in primary care and community settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration number<\/jats:title>\n                    <jats:p>NCT06401733<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/gerona\/glag192","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T15:07:17Z","timestamp":1785856037000},"source":"Crossref","is-referenced-by-count":0,"title":["A technology-blended exercise intervention for cognitive risk reduction and brain health in middle-aged and older adults with type 2 diabetes in Singapore: a mixed-methods study"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9297-0052","authenticated-orcid":false,"given":"Jinghua","family":"Zhang","sequence":"first","affiliation":[{"name":"Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore , Singapore,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0641-3060","authenticated-orcid":false,"given":"Wilson Wai San","family":"Tam","sequence":"additional","affiliation":[{"name":"Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore , Singapore,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhua","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore , Singapore,","place":["Singapore"]},{"name":"Immunology Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore , Singapore,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Chen","sequence":"additional","affiliation":[{"name":"Lucence Diagnostics PTE. 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