Exergaming improves neuronal activity and executive function in older adults with dementia

Findings of a small randomized trial of older adults with moderate dementia suggest that exergaming may be associated with greater improvements in brain neuronal activity and enhanced executive function task performance than regular aerobic exercise.

Exergaming encompasses both cognitive (ie, auditory and visual stimulation) and exercise training (ie, motor-sensory stimulation) and has been linked with neurocognitive health. [Games Health J 2016;5:100-107; PLoS One 2014;9:e101472] However, few studies have evaluated the joint effects of cognitive and exercise training in older individuals with dementia.

Present study investigated the effects of exergaming on cognitive and physical functions in older adults with moderate dementia. In total, 24 older adults with moderate dementia were randomized into either the exergame group (EXG; n=13; mean age, 78.8 years) or the aerobic exercise group (AEG; n=11; mean age, 81.2 years). All participants underwent a 2-week familiarization period before starting the 12-week intervention, where EXG participants engaged in a running-based exergame and AEG participants performed a cycling exercise 3 days per week. The target exercise intensity was 60–70 percent of the heart rate reserved, and exercise session duration was gradually increased over the course of intervention (weeks 1–2: 30 minutes; week 3: 35 minutes; weeks 4–5: 40 minutes; weeks 6–7: 45 minutes; weeks 8–12: 50 minutes). [J Med Internet Res 2023;25:e39993]

A modified version of the Eriksen flanker test was used to assess executive function before and after the 12-week exercise intervention. “We found a significantly shorter Ericksen flanker test congruent and incongruent reaction time [RT] following exergame training, which indicates greater facilitation of executive function,” reported the researchers.

“Moreover, exergaming generally yielded larger increases in neural activities related to attention and working memory vs aerobic exercise. Consistent with findings of previous studies, our study demonstrated that exergame training results in a significant improvement in information processing speed, suggesting that auditory, visual, and motor sensory stimulation during exergaming may accelerate information processing speed in older adults with dementia,” they added. [JMIR Serious Games 2019;7:e13575; Geriatr Nurs 2018;39:303-309]

In addition, compared with aerobic exercise, exergame training led to greater enhancement in lower body muscle strength and cardiorespiratory endurance. EXG participants showed a significantly increased number of steps in 2 minutes post-intervention (p=0.001) and full stands in 30 seconds post-intervention (p=0.001), whereas AEG participants achieved no significant change. Both EXG and AEG participants showed a significantly reduced distance between extended fingers and the toes postintervention implying greater lower body flexibility. Neither EXG nor AEG participants showed significant changes in upper body strength and flexibility following respective interventions.

“Regular participation in exergaming can be suggested as an effective alternative to aerobic exercise for treatment and prevention of dementia in older adults,” concluded the researchers. “However, studies with larger number of participants and non-exercise control groups are needed to confirm our findings.”