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STUDY PROTOCOL article

Front. Psychol.
Sec. Psychology of Aging
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1512175

Effects of Indoor Biophilic Environments on Cognitive Function in Elderly Patients with Diabetes: Study Protocol for a Randomized Controlled Trial

Provisionally accepted
Jiajia Dai Jiajia Dai 1,2Mohan Wang Mohan Wang 3Han Zhang Han Zhang 4Zhengfang Wang Zhengfang Wang 4Xue Meng Xue Meng 5,6Yanan Sun Yanan Sun 1,2Yuan Sun Yuan Sun 1,2Wenhui Dong Wenhui Dong 4Zhiying Sun Zhiying Sun 4Kuo Liu Kuo Liu 1,2*
  • 1 Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, Beijing, China
  • 2 Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
  • 3 School of Architecture, Harbin Institute of Technology (Shenzhen), Shenzhen, China
  • 4 Health Management Center, Beijing Aerospace General Hospital, Beijing, Beijing Municipality, China
  • 5 School of Architecture and Design, Harbin Institute of Technology, Harbin, China
  • 6 Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, Heilongjiang Province, China

The final, formatted version of the article will be published soon.

    The prevalence of cognitive impairment in elderly diabetic patients is increasing, highlighting the importance of exploring strategies to prevent and ameliorate cognitive impairment in this population. Previous studies have focused mostly on improving cognition in elderly diabetic patients through three methods: medication, cognitive training, and lifestyle intervention. However, few studies have investigated the role of indoor biophilic environments in improving cognition.Biophilic environments improve human health by integrating natural elements into indoor architectural settings and have demonstrated efficacy in reducing stress and improving cognition. Therefore, it is worth exploring the effects of indoor biophilic environments on cognition in elderly diabetic patients. This study aims to investigate the effects of indoor biophilic environments on cognition in elderly diabetic patients, and the potential mechanisms.Methods: This is a single-center, randomized controlled trial, which includes a shortterm VR intervention and a long-term real environment intervention. In the short-term intervention trial, 64 diabetic patients over 60 years old are randomly assigned to 1 of 7 intervention groups or a control group. All intervention groups are constructed by single or various combinations of the 3 indoor biophilic elements: natural decorative paintings, indoor potted plants, and ornamental fish. The primary outcome of the shortterm intervention trial is the cognitive scores assessed by DSST and BDS. In the longterm intervention trial, 240 diabetic patients over 60 years old will be randomly assigned to either the intervention group or the control group. The biophilic elements in long-term intervention will be determined based on the results of the short-term VR intervention trial. The primary outcomes of the long-term intervention trial are cognitive scores measured by DSST and MoCA, as well as concentrations of plasma p-tau181, esRAGE, and IL-6.The findings will be utilized to develop a restorative living environment for elderly patients with diabetes to improve cognition.

    Keywords: Indoor biophilic elements, Cognition, Elderly diabetic patients, virtual reality, ApoE4

    Received: 22 Oct 2024; Accepted: 07 Feb 2025.

    Copyright: © 2025 Dai, Wang, Zhang, Wang, Meng, Sun, Sun, Dong, Sun and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Kuo Liu, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.