Using a Digital-Based Mindfulness Curriculum to Enhance Healthy Aging Outcomes in Community-Dwelling Older Adults in Taiwan: Mixed Methods Feasibility Study.

An 8-week theory-based mindfulness curriculum combining mindfulness-based stress reduction, mindfulness-based elder care, and mindful sustainable aging with digital support improved mindfulness, sleep quality, aging perception, healthy aging outlook, and physical function in older community-dwelling adults in Taiwan. Cognition, heart rate variability, and physical activity showed no significant changes. Qualitative interviews indicated participants valued simple daily practices like mindful breathing and digital materials, though some with reading difficulties faced access challenges. The curriculum was developed using a modified Delphi method and tested in a mixed methods feasibility study with 10 older adults. The authors argue longer trials are needed to assess cognitive and physiological effects.

Study at a glance

Abstract

Taiwan's status as a super-aged society underscores the need for efficient strategies to promote healthy aging. While the benefits of mindfulness-based interventions for sleep and mental health are evident, there is a shortage of cultural adaptations for Taiwan's older adults. Current courses mainly focus on mindfulness-based stress reduction, while neglecting mindfulness-based elder care, and mindful sustainable aging principles. However, the abstract nature of some mindfulness concepts, combined with limited digital support and localized resources, makes it challenging for older adults to engage effectively. To enhance healthy aging outcomes in older community-dwelling adults in Taiwan, this study developed an 8-week theory-based mindfulness curriculum that combined the mindfulness-based stress reduction, mindfulness-based elder care, and mindful sustainable aging frameworks with digital health support. This research employed a mixed methods feasibility study design. We used the modified Delphi method in phase 1 to reach agreement on curriculum content and digital material selection. Ten older adults participated in the pilot study, which comprised phase 2. We used quantitative measurements to assess mindfulness, sleep quality, cognition, heart rate variability, perceptions of aging, healthy aging perspectives, and physical function and activity at baseline, at weeks 4 and 8, and at a 1-month follow-up. Qualitative interviews were conducted to gather insights into participants' experiences. Participants achieved significant improvements in mindfulness, sleep quality, aging perception, healthy aging outlook, and physical function during the study (all P<.05). Cognition, heart rate variability, and physical activity levels showed no significant changes throughout the study. The qualitative data supported these findings, as participants selected simple practices, such as mindful breathing, which they practiced daily to enhance their emotional well-being and social connections. Participants valued the digital learning materials for aiding their practice; however, some older adults with reading difficulties faced challenges accessing the content. Using the Delphi method resulted in an acceptable and feasible theory-based digitally supported mindfulness program that improved several indicators of healthy aging in older adults in Taiwan. Our findings need to be validated using longer trials to assess cognitive and physiological effects. Furthermore, digital accessibility requires further development.