The Effectiveness of Home-based Exergames Training on Cognition and Balance in Older Adults: A Comparative Quasi-Randomized Study of Two Exergame Interventions

Abstract Background and Objectives The effectiveness of exergames on fall risk and related physical and cognitive function in older adults is still unclear, with conflicting findings. The discrepancy in these results could be due to the different components and task-specific demands of individual exergame interventions. This open-label quasi-randomized study aimed to compare the efficacy of two different home-based dual-task exergame treatments on cognition, mobility, and balance in older people. Research Design and Methods 50 older adults (65-85 years of age) were allocated to one of two 8-week exergame interventions: Cognitive-Intensive Exergame Training (CIT) or Physical-Intensive Exergame Training (PIT). Cognitive functions, balance and mobility were assessed at baseline and after 8 weeks. Group×time interaction was measured by repeated-measure ANOVA, and both intention-to-treat (ITT) and per-protocol (PP) analyses were performed to assess the effectiveness of exergame interventions. Results ITT analyses showed that improvement in visual processing speed and visuospatial working memory was greater in the CIT group, with a medium effect size (P=0.04; η2=0.09 and P=0.01; η2=0.12). The improvement in verbal memory and attention was significant within both groups (P<0.05), but this improvement was not different between the groups (P>0.05). A significant improvement in balance was also observed in the PIT group, with a medium effect size (P=0.04; η2=0.09). Although mobility improved significantly in both groups (P<0.01), there was no significant difference between groups (P=0.08). These results were largely supported by the PP analysis. Discussion and Implications Dual-task exergame training can improve mobility and cognition in older adults. However, the different cognitive and physical demands of these interventions may have varying impacts on fall risk and related physical or cognitive functions. Therefore, a training program that includes both cognitive and physical domains with appropriate intensity is essential for the development of tailored exergame interventions to reduce fall risk in older adults.