The Effects of Exergaming on Executive and Physical Functions in Older Adults With Dementia: Randomized Controlled Trial

Abstract

Background Despite increasing interest in the effects of exergaming on cognitive function, little is known about its effects on older adults with dementia. Objective The purpose of this is to investigate the effects of exergaming on executive and physical functions in older adults with dementia compared to regular aerobic exercise. Methods In total, 24 older adults with moderate dementia participated in the study. Participants were randomized into either the exergame group (EXG, n=13, 54%) or the aerobic exercise group (AEG, n=11, 46%). For 12 weeks, EXG engaged in a running-based exergame and AEG performed a cycling exercise. At baseline and postintervention, participants underwent the Ericksen flanker test (accuracy % and response time [RT]) while recording event-related potentials (ERPs) that included the N2 and P3b potentials. Participants also underwent the senior fitness test (SFT) and the body composition test pre- and postintervention. Repeated-measures ANOVA was performed to assess the effects of time (pre- vs postintervention), group (EXG vs AEG), and group×time interactions. Results Compared to AEG, EXG demonstrated greater improvements in the SFT (F1.22=7.434, P=.01), reduction in body fat (F1.22=6.476, P=.02), and increase in skeletal mass (F1.22=4.525, P=.05), fat-free mass (F1.22=6.103, P=.02), and muscle mass (F1.22=6.636, P=.02). Although there was a significantly shorter RT in EXG postintervention (congruent P=.03, 95% CI 13.581-260.419, incongruent P=.04, 95% CI 14.621-408.917), no changes occurred in AEG. EXG also yielded a shorter N2 latency for central (Cz) cortices during both congruent conditions compared to AEG (F1.22=4.281, P=.05). Lastly, EXG presented a significantly increased P3b amplitude compared to AEG during the Ericksen flanker test (congruent: frontal [Fz] F1.22=6.546, P=.02; Cz F1.22=5.963, P=.23; parietal [Pz] F1.22=4.302, P=.05; incongruent: Fz F1.22=8.302, P=.01; Cz F1.22=15.199, P=.001; Pz F1.22=13.774, P=.001). Conclusions Our results suggest that exergaming may be associated with greater improvements in brain neuronal activity and enhanced executive function task performance than regular aerobic exercise. Exergaming characterized by both aerobic exercise and cognitive stimulation can be used as an effective intervention to improve cognitive and physical functions in older adults with dementia. Trial Registration Clinical Research Information Service KCT0008238; https://cris.nih.go.kr/cris/search/detailSearch.do/24170

Exergaming and cognitive functions in people with mild cognitive impairment and dementia: a meta-analysis

“…Eight studies used the intention-to-treat principle, 10 studies used the pre-protocol principle, and the remaining two studies did not describe the method of result analysis. Four studies were assessed as high risk of bias in one of the ROB-2 domains, including deviations from intended interventions 41 , measurement of the outcome 33 , and selective reporting of results 23 , 28 (Supplementary Table 3 ).…”

“…Sixteen studies did not recruit participants with MCI or dementia; 7 studies were not RCT; and 18 studies did not evaluate cognitive function (Supplementary Table 2). As a result, 20 RCTs were eligible for this systematic review and meta-analysis [11][12][13]22,23,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] (Fig. 1).…”

Realidad virtual inmersiva y su influencia en parámetros fisiológicos de personas sanas (Immersive virtual reality and its influence on physiological parameters in healthy people)

“…So far these studies have focused on whether these programs are feasible for different populations and whether the improvements in physical, cognitive and functional abilities generally attributed to traditional exercise, can be replicated or even improved by the use of fully (Bank et al, 2018;Barsasella et al, 2021;Benham et al, 2019;Campo-Prieto, Cancela-Carral, Alsina-Rey, et al, 2022;Campo-Prieto, Cancela-Carral, & Rodríguez-Fuentes, 2022a;Jones et al, 2018;A. Kim et al, 2017;Murray et al, 2007;Phu et al, 2019) or non-immersive (Maranesi et al, 2022;Wu et al, 2023) virtual environments. Kim et al, 2022 addressed their study to detect the presence of cybersickness by analyzing the impact of a 2-minute IVR exposure on physiological parameters, including blood tests.…”

Cardiorespiratory Exertion While Exergaming in Healthy Adults

“…한편, 새로운 엑서게임 형태인 Exerheart (D&J HUMAN CARE, EXER HEART, Korea)는 스텝기반 운동 장치로, 빠르게 스텝보드를 밟 으며 유산소 운동에 중점을 둔 게임을 포함하고 있다. 현재까지 Exerheart 엑서게임을 통해 보고된 연구들은 심혈관고위험군 환자들의 심 폐지구력 및 혈관내피세포기능의 향상과 심외막지방두께 감소 [23], 대 사증후군 환자들의 뇌기능 향상 [24], 치매환자들의 집행기능(Executive Functions) 및 신체기능 향상 [25], 당뇨병 환자들의 식후 혈당 감소 1과 같다.…”