Outdoor Nature-Based Activities for Mental Vitality and Cognitive Empowerment in Older Adults: A Randomized Controlled Trial Protocol

Background: Nature exposure has been associated with mental health and cognitive benefits among older adults. However, controlled trials evaluating specific types of nature-based interventions are limited. This study aims to examine the effects of two structured outdoor activities—walking with meaningful conversation and group meditation—on mental vitality and cognitive empowerment in elderly women. Methods: This is a three-arm parallel randomized controlled trial (RCT) enrolling 111 women aged ≥ 60 from 9 urban and rural health centers in Khafr County, Iran. Participants will be randomized into: (1) Walking with meaningful conversation group, (2) Meditation in nature group, and (3) Control group with no intervention. Each intervention consists of eight 2-hour sessions across 8 weeks. Assessments will occur at baseline, post-intervention (week 8), and 3-month follow-up using validated questionnaires on subjective vitality and cognitive empowerment. The Generalized Estimating Equation (GEE) model will be applied to analyze changes over time. Discussion: We hypothesize that both intervention groups will show significant improvements compared to the control, with walking expected to yield greater gains in mental vitality, and meditation to better enhance cognitive empowerment. Findings may support the implementation of community-based, non-pharmacological programs to promote active aging. Trial registration: This trial was registered in the Iranian Registry of Clinical Trials (IRCT20241023063481N1) on 18 February 2025.