Community-Empowerment and Environmental Enrichment-based Co-management (CEEEC) Model and Mechanisms for Improving Health of Older Stroke Patients With Multimorbidity

This study is a cluster randomized controlled trial with a 2×2 factorial design conducted in community health centers in Kunshan, Wuhan and Shanghai, China. It aims to evaluate the independent and combined effects of exercise and cognitive interventions on intrinsic capacity and related health outcomes among stroke survivors aged 60 years and older with hypertension or type 2 diabetes mellitus. Participants will receive either exercise training, cognitive training, combined training, or usual care over 20 week, followed by a 12\~24 month follow-up. Findings will inform integrated health management strategies for older adults with multimorbidity.

Inclusion Criteria: * Aged ≥60 years * The doctor diagnosed it as a stroke and it is in a stable stage (the diagnosis time is not limited) * Patients with concurrent hypertension and/or diabetes may also have other diseases at the same time * Be able to participate in a community intervention lasting for six months * Be informed and agree to participate in the research Exclusion Criteria: * With the aid of a walking aid (not a wheelchair), it is also impossible to walk independently to the community service center. * Lack basic communication skills and do not recognize Arabic numerals * Suffering from life-threatening diseases, with a survival expectation of less than 6 months, etc.