Physical ActivitiesNCT07554027
Effect of Episodic Future Thinking on Promoting Physical Activity Among Older Adults With Motoric Cognitive Risk Syndrome: A Randomized Controlled Trial
A study testing Episodic Future Thinking and Brochure-Based Health Education in people with Physical Activities and Motoric Cognitive Risk Syndrome, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.
Trial summary
Motor Cognitive Risk (MCR), a pre-dementia state characterized by the coexistence of subjective cognitive decline (SCD) and slow gait speed, has a high prevalence among community-dwelling older adults in China and is associated with significantly increased risks of progression to dementia and other adverse health… Read more about this study
- Who is it for?
- Ages 60 years and older
- Conditions the study is for
- Physical Activities, Motoric Cognitive Risk Syndrome
- What is being tested?
- Episodic Future Thinking and Brochure-Based Health Education
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 166 participants
- Where
- 1 siteChina
- Study dates
- May 2026to Mar 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 60 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Participants will be eligible for inclusion if they are 60 years of age or older and meet all of the following four criteria:
- 1. Subjective Cognitive Decline (SCD) Assessed using the Chinese version of the Subjective Cognitive Decline Questionnaire-9 (SCD-9). A total score greater than 5 is considered indicative of SCD.
- 2. Slow Gait Participants will walk 4 meters at their usual pace. Gait speed will be calculated using the recorded time, and gait speed <1.0 m/s will be classified as slow gait.
- 3. No Difficulty in Basic Activities of Daily Living (ADL) Participants must report no difficulty in the following six basic ADL domains: bathing, dressing, toileting, transferring, continence, and eating.
- 4. No Dementia No self-reported history of dementia and a Mini-Mental State Examination (MMSE) score of ≥24, indicating the absence of dementia.
Who cannot join
- Participants will be excluded if they meet any of the following conditions:
- 1. Severe visual or hearing impairment that interferes with communication or assessment.
- 2. Primary psychiatric disorders, such as schizophrenia or bipolar disorder.
- 3. Significant language or communication difficulties that prevent completion of assessments or participation in the intervention.
- 4. Severe diseases of major organs or systems, such as advanced heart failure, end-stage renal disease, or active malignancy, that may affect safety or participation.
- 5. Any other condition that, in the judgment of the research team, makes the participant unsuitable for the study.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
China1 site
The Second Affiliated Hospital of Medical College of Zhejiang University
Hangzhou, Zhejiang, 310009
Jingfen Jin, +86-0571-87783887, zrjzkhl@zju.edu.cn
About this study
Motor Cognitive Risk (MCR), a pre-dementia state characterized by the coexistence of subjective cognitive decline (SCD) and slow gait speed, has a high prevalence among community-dwelling older adults in China and is associated with significantly increased risks of progression to dementia and other adverse health outcomes. Physical activity is the most cost-effective non-pharmacological intervention for slowing cognitive decline and the modifiable factor with the greatest contribution to dementia prevention. However, older adults with cognitive impairment commonly face behavioral challenges such as insufficient physical activity and difficulty maintaining adherence. Episodic Future Thinking (EFT), a novel intervention strategy grounded in health psychology and behavioral economics, has been shown to promote healthy behaviors by reducing delay discounting rates and enhancing future orientation. The goal of this randomized controlled study is to test the effect of EFT intervention in promoting physical activity among older adults with MCR.
- Being tested
- Episodic Future Thinking, Brochure-Based Health Education
- Keywords
- Physical Activities, Episodic Futhre Thinking, Motoric Cognitive Risk Syndrome
- Medical subject headings
- Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Episodic Future ThinkingBehavioural
Participants will receive a 12-week structured Episodic Future Thinking (EFT) intervention.
At baseline, participants select multiple Daily Events (activities they can currently perform independently) and Aspirational Events (activities they wish to regain or improve) from a pre-developed event library. Each event has a corresponding structured video. Video sessions include relaxation, vivid future scenarios, sensory cues, and explicit links between physical activity and future functional independence.
The intervention progresses across three phases (Weeks 1-4, 5-8, 9-12), shifting from Daily Events to Aspirational Events with gradually reduced frequency(from 4 days/week, 2 sessions/day to 4 days/week, 1 session/day). Participants receive individualized audio files with reminder messages and attend biweekly in-person group sessions where standardized FET videos are viewed under staff supervision. Adherence is monitored through WeChat feedback and weekly check-ins.
Brochure-Based Health EducationOther
Participants will receive a one-time standardized health education session immediately after baseline assessment. The session is delivered face-to-face by trained research staff and provides foundational knowledge about MCR syndrome, including its definition, clinical significance, associated health risks, and the role of physical activity in maintaining cognitive and physical function.
Participants are provided with a printed educational brochure titled Exercise Guidance for Older Adults with Motoric Cognitive Risk Syndrome. The brochure includes evidence-based recommendations on exercise types (aerobic, balance, flexibility, strength), recommended frequency and duration based on expert consensus, and safety precautions for older adults with MCR engaging in physical activity.
| Study group | Role | What they receive |
|---|---|---|
| EFT group | Experimental | For participants in this group, on the basis of health education regarding physical exercise for individuals with MCR, episodic future thinking intervention will be additionally provided. Receives: Behavioral: Episodic Future Thinking; Other: Brochure-Based Health Education |
| Control group | Other | Participants in this group will be provided with health education regarding physical exercise for individuals with MCR. Receives: Other: Brochure-Based Health Education |
What is being measured
The primary outcome is the main question the study is designed to answer.
Intention to engage in physical activity
Behavioral intention toward physical activity was assessed using the Behavioral Intention subscale of the Theory of Planned Behavior Exercise Questionnaire developed by Hu et al. Participants rated three items (e.g., their acceptance, intention, and plan to engage in ≥3 sessions of ≥20 minutes of exercise per week over the next four weeks) on a 6-point Likert scale, with higher scores indicating stronger behavioral intention.
Measured: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4)
Secondary outcomes (9)
Physical activity level
Physical activity level was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), which includes seven items evaluating the frequency and duration of vigorous activity, moderate activity, and walking for at least 10 minutes during the past week. Weekly activity levels (MET-minutes/week) were calculated by multiplying the MET value of each activity category by the reported frequency and duration.
Measured: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Physical Activity Compliance Rate
Physical activity compliance was determined based on WHO guidelines. Participants were classified as meeting physical activity recommendations if they achieved at least 150-300 minutes of moderate-intensity aerobic activity per week or 75-150 minutes of vigorous-intensity activity per week, as calculated from the IPAQ-SF. The compliance rate was defined as the proportion of participants who met these criteria.
Measured: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Delay Discounting Rate
Delay discounting was assessed using a computerized intertemporal choice task adapted from Figner et al. Participants completed 60 trials in which they chose between a smaller-sooner (SS) reward and a larger-later (LL) reward across varying delays and reward differences. The discounting parameter k was estimated using a hyperbolic discounting model (V = A / (1 + αk)), with higher k values indicating steeper delay discounting.
Measured: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4)
Consideration of future consequences
Consideration of future consequences was measured using the short version of the Consideration of Future Consequences Scale (CFC-S), which includes two subscales: CFC-Future (5 items) and CFC-Immediate (7 items). All items are rated on a 7-point Likert scale, and subscale scores are calculated as the mean of their respective items, with higher scores indicating a stronger tendency to consider future outcomes.
Measured: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4)
Multidimensional Outcome Expectations for Exercise Scale
Outcome expectations for exercise were assessed using the Multidimensional Outcome Expectations for Exercise Scale (MOEES), which includes three subscales: physical (6 items), social (4 items), and self-evaluative (5 items). Participants rated each item on a 7-point Likert scale (1 = strongly disagree to 7 = strongly agree) and additionally indicated how soon they expected each outcome to occur using a 7-point temporal expectancy scale (1 = distant future to 7 = immediate). Higher scores reflect more positive and more immediate outcome expectations for exercise.
Measured: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Subjective Cognitive Decline Questionnaire
Subjective cognitive decline was assessed using the 9-item Subjective Cognitive Decline Questionnaire (SCD-9), which evaluates perceived changes in memory and other cognitive domains, including overall memory problems and comparisons with past cognitive functioning. Each item is scored and summed to generate a total score, with higher scores indicating greater subjective cognitive decline. A cutoff score of >5 has been suggested to indicate abnormal subjective cognitive decline in Chinese populations.
Measured: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Short Physical Performance Battery
Lower-extremity physical function was assessed using the Short Physical Performance Battery (SPPB), which includes three subtests: gait speed, balance tests, and the chair stand test. The SPPB provides a composite score reflecting balance, lower-limb strength, and functional mobility in older adults.
Measured: At baseline (T0), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Handgrip Strength
Handgrip strength was measured using a handheld dynamometer. Participants performed two trials with each hand, and the highest value (in kilograms) was recorded as the final grip strength. Higher values indicate better upper-extremity muscle strength.
Measured: At baseline (T0), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Calf Circumference
Calf circumference was measured using a flexible, non-elastic tape at the point of the greatest calf girth while the participant was standing with feet shoulder-width apart. Measurements were recorded in centimeters, with larger values indicating greater lower-limb muscle mass.
Measured: At baseline (T0), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Apr 2026
- Study startMay 2026 (estimated)
- Primary completionDec 2026 (estimated)
- Study completionMar 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Physical ActivitiesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 166 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Second Affiliated Hospital, Zhejiang University, School of Medicine
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jingfen Jin, Principal investigator, Second Affiliated Hospital, Zhejiang University, School of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07554027
- Sponsor's protocol ID
- 2026-0328
- Status last verified
- Apr 2026
- First submitted
- 21 Apr 2026
- Last updated
- 28 Apr 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Episodic Future Thinking on Promoting Physical Activity Among Older Adults With Motoric Cognitive Risk Syndrome: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07554027
- Acronym / sponsor ID
- 2026-0328
- Keywords
- Physical Activities, Episodic Futhre Thinking, Motoric Cognitive Risk Syndrome
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 166 participants (estimated)
- Lead sponsor
- Second Affiliated Hospital, Zhejiang University, School of MedicineUniversity, hospital or other
- Study start
- May 2026 (estimated)
- Primary completion
- Dec 2026 (estimated)
- Study completion
- Mar 2027 (estimated)
- First posted
- 28 Apr 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Motor Cognitive Risk (MCR), a pre-dementia state characterized by the coexistence of subjective cognitive decline (SCD) and slow gait speed, has a high prevalence among community-dwelling older adults in China and is associated with significantly increased risks of progression to dementia and other adverse health outcomes. Physical activity is the most cost-effective non-pharmacological intervention for slowing cognitive decline and the modifiable factor with the greatest contribution to dementia prevention. However, older adults with cognitive impairment commonly face behavioral challenges such as insufficient physical activity and difficulty maintaining adherence. Episodic Future Thinking (EFT), a novel intervention strategy grounded in health psychology and behavioral economics, has been shown to promote healthy behaviors by reducing delay discounting rates and enhancing future orientation. The goal of this randomized controlled study is to test the effect of EFT intervention in promoting physical activity among older adults with MCR.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| EFT group | Experimental | Behavioral: Episodic Future Thinking, Other: Brochure-Based Health EducationFor participants in this group, on the basis of health education regarding physical exercise for individuals with MCR, episodic future thinking intervention will be additionally provided. |
| Control group | Other | Other: Brochure-Based Health EducationParticipants in this group will be provided with health education regarding physical exercise for individuals with MCR. |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Participants will be eligible for inclusion if they are 60 years of age or older and meet all of the following four criteria:
- 1. Subjective Cognitive Decline (SCD) Assessed using the Chinese version of the Subjective Cognitive Decline Questionnaire-9 (SCD-9). A total score greater than 5 is considered indicative of SCD.
- 2. Slow Gait Participants will walk 4 meters at their usual pace. Gait speed will be calculated using the recorded time, and gait speed <1.0 m/s will be classified as slow gait.
- 3. No Difficulty in Basic Activities of Daily Living (ADL) Participants must report no difficulty in the following six basic ADL domains: bathing, dressing, toileting, transferring, continence, and eating.
- 4. No Dementia No self-reported history of dementia and a Mini-Mental State Examination (MMSE) score of ≥24, indicating the absence of dementia.
Key exclusion criteria (6 listed)
- 1. Severe visual or hearing impairment that interferes with communication or assessment.
- 2. Primary psychiatric disorders, such as schizophrenia or bipolar disorder.
- 3. Significant language or communication difficulties that prevent completion of assessments or participation in the intervention.
- 4. Severe diseases of major organs or systems, such as advanced heart failure, end-stage renal disease, or active malignancy, that may affect safety or participation.
- 5. Any other condition that, in the judgment of the research team, makes the participant unsuitable for the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Episodic Future ThinkingParticipants will receive a 12-week structured Episodic Future Thinking (EFT) intervention. At baseline, participants select multiple Daily Events (activities they can currently perform independently) and Aspirational Events (activities they wish to regain or improve) from a pre-developed event library. Each event has a corresponding structured video. Video sessions include relaxation, vivid future scenarios, sensory cues, and explicit links between physical activity and future functional independence. The intervention progresses across three phases (Weeks 1-4, 5-8, 9-12), shifting from Daily Events to Aspirational Events with gradually reduced frequency(from 4 days/week, 2 sessions/day to 4 days/week, 1 session/day). Participants receive individualized audio files with reminder messages and attend biweekly in-person group sessions where standardized FET videos are viewed under staff supervision. Adherence is monitored through WeChat feedback and weekly check-ins. | Behavioural | EFT group |
| Brochure-Based Health EducationParticipants will receive a one-time standardized health education session immediately after baseline assessment. The session is delivered face-to-face by trained research staff and provides foundational knowledge about MCR syndrome, including its definition, clinical significance, associated health risks, and the role of physical activity in maintaining cognitive and physical function. Participants are provided with a printed educational brochure titled Exercise Guidance for Older Adults with Motoric Cognitive Risk Syndrome. The brochure includes evidence-based recommendations on exercise types (aerobic, balance, flexibility, strength), recommended frequency and duration based on expert consensus, and safety precautions for older adults with MCR engaging in physical activity. | Other | Control group, EFT group |
Primary outcome
Intention to engage in physical activity
Time frame: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4)
Behavioral intention toward physical activity was assessed using the Behavioral Intention subscale of the Theory of Planned Behavior Exercise Questionnaire developed by Hu et al. Participants rated three items (e.g., their acceptance, intention, and plan to engage in ≥3 sessions of ≥20 minutes of exercise per week over the next four weeks) on a 6-point Likert scale, with higher scores indicating stronger behavioral intention.
9 secondary outcomes
Physical activity level
Time frame: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Physical Activity Compliance Rate
Time frame: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Delay Discounting Rate
Time frame: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4)
Consideration of future consequences
Time frame: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4)
Multidimensional Outcome Expectations for Exercise Scale
Time frame: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Subjective Cognitive Decline Questionnaire
Time frame: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Short Physical Performance Battery
Time frame: At baseline (T0), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Handgrip Strength
Time frame: At baseline (T0), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Calf Circumference
Time frame: At baseline (T0), week 12 (T3), and four weeks after the end of the intervention (week 16, T4).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Apr 2026.
- Individual participant dataSharing planned: No
Related trials for Physical Activities
RecruitingPhase 2
Neurovascular Regulation During Exercise in Humans With Chronic Kidney Disease: Sympatholysis in CKD
Chronic Kidney Disease
Not yet recruiting
Combined Versus Multicomponent Training in People With Chronic Kidney Disease Stages 3a and 3b
Chronic Kidney Disease Stage 3A, Chronic Kidney Disease Stage 3B
Recruiting
Understanding the Feasibility of a Co-designed Pre-radiotherapy Exercise Programme - A Single-arm Study
Lung Cancer
Not yet recruiting
Integrated Core Stability Exercises and Yoga Program on Premenstrual Syndrome
Premenstrual Syndrome
RecruitingPhase 2
Spironolactone for Pulmonary Arterial Hypertension
Pulmonary Arterial Hypertension
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Jingfen Jin principal investigator
Second Affiliated Hospital, Zhejiang University, School of Medicine
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Episodic Future Thinking and Brochure-Based Health Education in people with Physical Activities and Motoric Cognitive Risk Syndrome, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 28 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Jingfen Jin (+86-0571-87783887, zrjzkhl@zju.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Intention to engage in physical activity (time frame: At baseline (T0), week 4 (T1), week 8 (T2), week 12 (T3), and four weeks after the end of the intervention (week 16, T4)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Apr 2026.