Augmented reality-assisted Tai Chi for adults with diabetes-associated cognitive impairment: study protocol for a randomised controlled trial

Introduction Diabetes-associated cognitive impairment (DACI) undermines diabetes self-management and is associated with increased morbidity and mortality. Although mind-body exercise may improve cognition, its benefits are often limited by the lack of timely, precise, individualised instruction and feedback in adults with cognitive impairment. Augmented reality (AR) systems can deliver performance-adaptive, visually anchored cues and auditory prompts in real-world settings, but their cognitive and metabolic benefits in DACI remain unknown. This trial will compare AR-assisted Tai Chi (iTaiChi), instructor-led Tai Chi (TaiChi) and standard care in adults with DACI and explore underlying metabolic and neurobiological mechanisms. Methods and analysis In this randomised controlled trial, 246 community-dwelling adults aged 45–75 years with DACI will be enrolled and randomly allocated in a 1:1:1 ratio to a TaiChi group, an iTaiChi group or a standard care group. All participants will receive standard care. In addition, participants assigned to the two exercise groups will undertake a standardised Yang-style 24-form Tai Chi programme three times weekly for 12 weeks. The primary outcome is the change in Montreal Cognitive Assessment Score. Secondary outcomes include physical health related parameters and brain health related parameters. Ethics and dissemination This study was approved by the Ethics Committee of Shanghai Sixth People’s Hospital (Approval No. 2025–017). Dissemination of the findings will include peer-reviewed publications, conference presentations and media releases. Trial registration number ChiCTR2500111614.