A study of the multicomponent therapeutic recreation function intervention strategy by a systematic review and analysis of the cognitive intervention program for the oldest old

This study aims to explore functional intervention strategies for multidimensional therapeutic recreation programs to alleviate cognitive decline and psychological and social isolation among oldest-old adults. To this end, a mixed-methods approach was employed, sequentially applying a systematic literature review and meta-analysis of experimental research articles published in Korea from 2010 to 2024, an investigation of current conditions using a questionnaire survey of oldest-old adults attending senior welfare centers in 5 districts of D Metropolitan City (final 216 participants), in-depth interviews (FGI 25 participants), and field observations, and an analytic hierarchy process (AHP) involving 9 experts. The meta-analysis confirmed that nonpharmacological interventions increased life satisfaction and significantly reduced depression among oldest-old adults. Analysis of conditions in the field revealed that existing programs were disproportionately focused on cognitive and social stimulation, creating a mismatch with participants’ physical and emotional needs, and insufficient consideration of health status and one-off implementation were identified as major barriers. The AHP analysis showed that the weights of the major domains, in descending order, were physical (.272), psychological (.255), cognitive (.249), and social (.224) stimulation, and key content identified for each domain included ‘well-being dance’ (physical), ‘singing’ (psychological), ‘drawing’ (cognitive), and ‘conversation companion’ (social). This study demonstrated the need for individually tailored assessment protocols and an evidence-based multidimensional integrated intervention model that considers the characteristics of oldest-old adults, and can be used as practical guidelines in health and welfare settings.