Among Asian countries, Japan is the fastest-aging country followed by Taiwan. According to statistical data from 2018, 3.31 million people in Taiwan are aged 65 years or older, and they account for 14.1% of Taiwan's population. Taiwan is projected to become a super-aged society by 2025, and the proportion of older adults in Taiwan is projected to exceed 20.0%.1 To manage population aging, countries must solve problems like expensive medical expenses and the need to care for older adults. Methods that can effectively reduce the fiscal burden include increasing the efficiency of medical resource use in the context of older adult care, delaying the aging of older adults, and improving the physical and mental health of older adults.
Elderly people often suffer from poor physical activity due to physical aging,2,3 depression and loneliness,4, 5, 6 widowhood and the death of relatives and friends,7, 8, 9 a lack of social support,6 the loss of the right to select one's living environment,10 and living in an unfriendly living environment11 lead to the deterioration of quality of life and the increase of life stress.12,13 These negative experiences cause the deterioration of the health of the elderly and even increase the risk of death. Physiological aging will also cause the decline of working memory and dementia.14 How we can improve the unfavorable factors in the quality of life, relieve stress perception, and improve the working memory of the elderly are issues that should receive attention in aging countries.
Horticultural therapy is mild and non-invasive, making it suitable for patients with diverse characteristics. Previous studies have shown that horticultural activities can improve the life satisfaction of individuals and optimize their quality of life.15, 16, 17, 18 Horticultural activities can reduce loneliness, depression, and negative emotions in older adults to improve psychological health,19, 20, 21, 22, 23 and can help to delay the aging process, maintain normal physiological function, improve concentration, and prevent dementia.24, 25, 26, 27 Taiwan is starting to implement horticultural therapy. To date, many studies have focused on the psychological benefits that older adults can gain through horticultural activities, but few have investigated the effects of horticultural activities on cognitive function. Therefore, this study designed the "nonequivalent pretest-posttest control group design", hoping to verify the research hypothesis that "horticultural activities can improve the quality of life of community-dwelling older adults, reduce stress perception, and increase working memory capacity", and serve as a reference for designing activity plans for community-dwelling older adults.
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