Effects of Different Exercise‐Led Strategies on Mental, Nutritional, Physical and Cognitive Health in Community‐Dwelling Older Adults: A Quasi‐Experimental Study

ABSTRACT Introduction Exercise interventions are widely used to promote physical and psychosocial health in community‐dwelling older adults; however, the comparative effects of human‐guided and artificial intelligence (AI)‐based exercise delivery on sleep and cognitive outcomes remain insufficiently understood. This study compared the effects of human‐guided versus AI‐based exercise programmes on multiple health domains in older adults. Methods A 12‐week quasi‐experimental study was conducted with two groups: a human‐guided exercise programme (HGEP) and an AI‐based exercise programme (AIEP). Outcomes included depression, sleep quality, well‐being, nutritional status, sarcopenia risk and cognitive function, assessed using validated instruments. Generalised estimating equation models were applied to examine time effects and group‐by‐time interactions. Results Significant main effects of time were observed for depression, well‐being, sarcopenia risk, sleep quality and cognitive function, indicating overall post‐intervention improvement. Notably, significant group‐by‐time interactions favoured the AIEP for sleep quality and cognitive function. Improvements in sleep quality should be interpreted cautiously due to a floor effect in the human‐guided group, whereas the cognitive benefit observed in the AI‐based group may reflect additional attentional and executive demands associated with real‐time feedback and performance monitoring. Conclusion Both exercise delivery strategies yielded beneficial effects across multiple health domains. AIEPs may provide added advantages for sleep and cognitive outcomes, highlighting their potential role as a complementary approach in community‐based exercise interventions for older adults. Implications for Practice These findings support integrating AI‐assisted exercise into community and nursing practice as a scalable, accessible alternative to instructor‐led programs, enhancing reach and providing flexible, personalized support for older adults’ health.