Evaluating the Cognitive Impact of Exergames in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis
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Background: Cognitive decline in older adults is a growing global concern. Exergames, which combine physical exercise with cognitive training in an interactive digital environment, have shown promise in mitigating this decline.Objective: To assess the effectiveness of exergames in improving cognitive function among community-dwelling older adults through a systematic review and meta-analysis.Methods: A systematic search was conducted across PubMed, ScienceDirect, SpringerLink, ACM, and IEEE databases for studies published between January 2014 and June 2024. Studies were included if they: (1) involved participants with mean age ≥60 years, (2) implemented exergame interventions in community settings, (3) included pre- and post-cognitive assessments, and (4) provided sufficient data for effect size calculation. The analysis examined effects across different populations (healthy, mild cognitive impairment [MCI], and dementia), exergame types, and various cognitive domains.Results: Ten studies comprising 690 participants (EXG=350, Control=340) met inclusion criteria. The pooled effect size was 0.1327 (95% CI 0.066-0.199, P< .001), indicating significant positive effects of exergames on cognition. Subgroup analyses revealed that individuals with MCI showed the largest benefits (g=0.256, 95% CI 0.11-0.40, P=.003), followed by cognitively healthy older adults (g=0.132, 95% CI 0.03-0.23, P=.013). Aerobic exergames (g=0.12, 95% CI 0.01-0.22, P=.002) and combined aerobic and non-aerobic exergames (g=0.291, 95% CI 0.12-0.46, P=.002) demonstrated significant effects, but not in non-aerobic exergame. Among cognitive domains, memory (g=0.179, 95% CI 0.03-0.33, P=.021) and processing speed (g=0.337, 95% CI 0.31-0.37, P< .001) showed significant improvements.Conclusions: Exergames provide significant cognitive benefits for community-dwelling older adults, with particularly strong effects for individuals with MCI. Combined aerobic and non-aerobic exergames appear most effective. These findings support the use of exergames as a practical tool for cognitive enhancement in community and residential environments.
