The (cost-) effectiveness of exergaming in people living with dementia and their informal caregivers: protocol for a randomized controlled trial

Abstract

Background: Physical activity is linked to benefits such as increased physical fitness, cognition, emotional and social functioning, general health and well-being in older people. Some evidence suggests that this also applies to people living with dementia. However, it can be harder for them to perform physical activities, due to several barriers, such as issues with orientation and balance problems. A relatively new type of physical activity called exergaming may help them overcome these barriers. Exergaming is "physical exercise interactively combined with cognitive stimulation in a gaming environment". The aim of our study is to evaluate the effectiveness and cost-effectiveness of exergaming compared to regular activities in people living with dementia, who attend day-care centres. Additionally, we want to investigate whether the exergaming activity for the person living with dementia, also (indirectly) affects the informal caregiver, as well as which facilitators and barriers to implementation of exergames for this target group exist. Methods: A cluster Randomized Controlled Trial (RCT), with economic and process evaluations alongside will be carried out. In the Netherlands, 24 day-care centres are randomized in the experimental or control group. The study group will consist of 224 dyads (community-dwelling participants with dementia and their informal caregivers), who are interviewed at baseline, and at 3 and 6 months of follow-up. The participant with dementia has to visit the day-care centre for at least two days per week, have a diagnosis of mild to moderate dementia and have an informal caregiver present, who is willing to participate. Societal cost data will be collected during interviews, using healthcare utilization diaries, and from day-care centres. The process evaluation will only involve the experimental group, and will include an online survey, qualitative interviews and focus groups. Discussion: This study will contribute to the evidence base that more effective exercise among people with dementia will result in positive effects on their wellbeing and quality of life. This will motivate people with dementia to be physically active. We also envision that there might be a positive effect on the burden of care experienced by their informal caregivers.

The efficacy of exergaming in people with major neurocognitive disorder residing in long-term care facilities: a pilot randomized controlled trial

“…Finally, implementation research is needed to explore the (cost-)effectiveness of exergaming in people with MNCD in psychiatric and residential care. Such trials are ongoing [ 92 ].…”

Cost‐effectiveness of exergaming compared to regular day‐care activities in dementia: Results of a randomised controlled trial in The Netherlands

“…We performed an economic evaluation alongside a cluster randomised controlled trial (RCT) evaluating the effectiveness of exergaming (van Santen et al., 2019). In summary, an independent researcher used Random Allocation Software to randomise DCCs to the experimental (exergaming) group or the control (traditional, non‐exergaming activities) group (Saghaei, 2004).…”

“…The RCT was approved by the Medical Ethics Committee (METc) of the Amsterdam University Medical Centers (UMC), location VUmc (VUmc; NL58227.029.16) and registered in the Netherlands Trial Register (NTR5537/NL5420). The study protocol of the complete RCT was published elsewhere but is summarised here (van Santen et al., 2019).…”

“…In addition, DCC staff encouraged them to participate in the exergaming intervention (interactive cycling) at least twice a week for 6 months. If the DCC did not have an interactive cycling system, they had to buy one of the following systems, which were offered at a discount: DiFiets, Fietslabyrint, PraxFit, or SilverFit Mile (van Santen et al., 2019). While cycling on a stationary bicycle (i.e., home trainer), the participant sees a previously selected route on a connected screen.…”

Effects of Exergaming on Cognitive and Social Functioning of People with Dementia: A Randomized Controlled Trial

“…For this study, DCCs had to buy or lease one of the following systems at a discount: DiFiets, Fietslabyrint, PraxFit, or SilverFit Mile. 31 Various brands of equipment were used, but according to experts and care professionals involved in exergaming, these did not vary significantly. The costs ranged from 1500 to 4700 euros.…”