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Exergaming for dementia and mild cognitive impairment
Alexandra Voinescu1, Themis Papaioannou1, Karin Petrini1,2
1Department of Psychology, University of Bath, Bath, UK.
The Cochrane Database of Systematic Reviews
|September 25, 2024
Summary
Exergaming may enhance cognitive function in dementia and mild cognitive impairment (MCI) patients, but evidence is very uncertain. This technology-driven intervention shows potential when compared to usual care, not specific physical activities.
Area of Science:
- Gerontology and Rehabilitation Medicine
- Neuroscience and Cognitive Health
- Human-Computer Interaction and Digital Health
Background:
- Dementia and mild cognitive impairment (MCI) significantly increase disability and dependency in older adults.
- Current therapeutic options for these conditions are limited.
- Exergaming, a blend of physical exercise and cognitive tasks using technology, presents a potential intervention.
Purpose of the Study:
- To evaluate the impact of exergaming interventions on physical and cognitive outcomes.
- To assess changes in activities of daily living (ADL) in individuals with dementia and MCI.
- To synthesize evidence from randomized controlled trials (RCTs) on exergaming's efficacy and safety.
Main Methods:
- A systematic search of multiple databases (e.g., MEDLINE, Embase, PsycINFO) was conducted.
- Included RCTs involved participants with dementia or MCI engaged in moderate-to-vigorous intensity physical activity via virtual reality (VR) or interactive technology.
- Data extraction, risk of bias assessment (RoB 2), and certainty of evidence evaluation (GRADE) were performed independently by two reviewers.
Main Results:
- Eleven studies (2014-2023) involving 536 participants (308 MCI, 228 dementia) were included.
- Exergaming may improve global cognitive functioning in dementia and MCI compared to control groups, though evidence is very uncertain.
- Evidence regarding physical functioning, ADL, and adverse effects remains very uncertain due to high risk of bias and limited data.
Conclusions:
- The overall evidence for exergaming's effects on physical, cognitive, and daily living outcomes in dementia and MCI is of very low certainty.
- A potential cognitive benefit was observed only when exergaming was compared to inactive controls, not active alternatives like specific exercises.
- The safety of unsupervised home-based exergaming remains unknown, as all included studies involved controlled, supervised environments.
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