Effects of forest bathing and the influence of exposure levels on cognitive health in the elderly: Evidence from a suburban forest recreation area

Using nature for cognitive enhancement has great potential. The potential effects of engagement with nature on cognitive aging have been receiving attention, particularly due to the challenges posed by an aging society. Forest bathing involves structured therapeutic recreational activities that could improve cognitive performance within a forest environment. However, the frequency, intensity, and duration of exposure to nature may hold different degrees of importance when it comes to health outcomes. In this study, a within-subjects design experiment was used to evaluate cognitive responses before and after participation among the elderly in a self-guided forest bathing program. Objective exposure metrics, including frequency of visits, walking distance, and time spent in the forest over a week, were employed to investigate subjects’ cognitive enhancement. The results revealed significant improvements in cognitive performance indicators. Through the Stroop test, participants showed reduced completion times in all sections after engaging in the self-guided forest bathing program. The Forward Digit Span Task and the Remote Associates Test scores displayed a significant increase following the self-guided forest bathing, indicating improvements in working memory and creativity, respectively. A negative correlation was observed between the change in time required to complete the Stroop task section involving color identification of neutral words and the frequency of forest bathing practices, suggesting that more frequent forest bathing practices may enhance the attentional control of the elderly. Moreover, a positive correlation was identified between the change in the backward Digit Span Task score and the frequency of self-guided forest bathing practices over a week, suggesting that regular engagement in forest bathing may have a positive impact on enhancing the working memory of the elderly.