Enhancing Physical Reserve to Promote Resilience in Physically Frail Older Adults

The goal of this clinical trial is to assess the efficacy of combined aerobic and resistance training in enhancing physical reserve in older adults with physical frailty. Investigator contend that enhanced physical reserve will enable preservation of cognitive and physical function. The main questions aims to answer are: (1) Compared with usual care (i.e., CON), will 3-month aerobic and resistance training (ATRT) improve physical reserve in older adults with physical frailty? (2) Compared with CON, will ATRT lead to changes in the neural network organization? (3) Will improved physical reserve lead to better maintenance of cognitive and physical functioning in spite of presence of white matter hyperintensities (WMH)?

Inclusion Criteria: 1. are community-dwelling (i.e., not residing in a nursing home or extended care unit) ; 2. scored \< 9/12 on the SPPB; 3. scored \>18/30 on the MoCA; 4. are able to walk independently; use of walking aid is acceptable; 5. are able to safely engage in exercise as indicated by the Physical Activity Readiness Questionnaire Plus33 and confirmed by their physician; 6. have internet at home; and 7. are able to provide written informed consent. Exclusion Criteria: 1. diagnosed with dementia or stroke; 2. self-report engaging in strength and balance training exercises \> two-times-per-week in the 3 months prior to screening; 3. unable to understand, speak, and read Cantonese/Chinese/English proficiently; and 4. contraindications for MRI such as MRI-incompatible implants.