Journal of the American Medical Directors Association · Oct 31, 2025

Effectiveness of a Community-Based eHealth Program on Self-Care, Cognition, and Health Outcomes of Older Adults With Chronic Diseases: A Multi-Site Cluster-Controlled Trial

By Wu XV, Yap XY, Feng RC et al.

OBJECTIVE: The growing prevalence of chronic diseases among the older population has become a global public health concern. This study aimed to examine the effects of a 12-week Community-based eHealth Program (CeHP) in enhancing the self-care, cognition, and health outcomes for community-dwelling older adults with chronic diseases. DESIGN: A nonrandomized cluster-controlled trial was conducted. The CeHP consisted of 7 in-person sessions at the Active Ageing Centres (AACs) and 5 virtual sessions through Care4Senior App. SETTING AND PARTICIPANTS: Participants were older adults recruited from 11 AACs affiliated with Community Health Posts located in the eastern region of Singapore. METHODS: Six AACs served as the intervention group where 5 AACs served as control. The outcome measures included self-care abilities of chronic illness, cognition, health literacy, healthy aging practice, empowerment, social support, and physical function. Outcomes measured at baseline, immediate postintervention, and 6-month follow-up were modeled at the participant level using a likelihood-based linear mixed model for repeated measures, incorporating random effects for clusters (AACs). RESULTS: A total of 108 participants (n = 61 in intervention; n = 47 in control) completed the study. The CeHP intervention resulted in significant effect on the cognitive processing speed and healthy aging among community-dwelling older adults with chronic diseases. However, no significant difference was observed on other health outcomes. CONCLUSIONS AND IMPLICATIONS: eHealth solutions are gaining prominence in improving quality of care and changing how individuals manage their health. However, disparities in digital access, technological proficiency, and eHealth literacy continue to impact on the vulnerable older population. Further research could continue to explore eHealth interventions and support systems to minimize the barriers to eHealth uptake among older adults.

doi.org/10.1016/j.jamda.2025.105956PubMed 41167590Interventions