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Are gamifying exergames the future of intervention for people with dementia? Systematic review and meta-analysis
Elena Papamichael1, Irene-Chrysovalanto Themistocleous1, Stelios Hadjisavvas1
1Department of Health Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus.
Background:
Gamified exergaming has emerged as a promising approach for enhancing cognitive and motor function in older adults, yet its effectiveness in people with dementia remains unclear. Existing research has largely focused on individuals with mild cognitive impairment, leaving a gap in understanding how these interventions perform in populations with more advanced cognitive decline.
Objective:
The primary goal of this study was to systematically evaluate and quantify the effects of gamified exergaming on cognitive function. Secondary, to evaluate motor performance, and activities of daily living (ADL) in individuals with dementia compared with non-exergaming or standard care interventions.
Methods:
A systematic search of MEDLINE/PubMed, Cochrane CENTRAL, and EBSCO (2016-2026) identified randomized controlled trials involving exergaming interventions for people with dementia. Nine studies met the inclusion criteria. Risk of bias was assessed using the RoB2 tool. Meta-analyses were conducted using random-effects models, with outcomes synthesized for MoCA, MMSE, ADL, and motor function (SPPB).
Results:
A total of 717 participants were included. Exergaming produced a significant improvement in global cognition measured by the MoCA (p = 0.007). No significant effects were observed for MMSE (p = 0.065), ADL performance (p = 0.489), or motor function assessed with the SPPB (p = 0.182). Considerable heterogeneity was present in motor outcomes. Most interventions used non-immersive VR platforms, with substantial variation in duration, frequency, and training intensity.
Conclusion:
Gamified exergaming demonstrates a meaningful positive effect on global cognition in individuals with dementia, while evidence for motor and functional improvements remains inconclusive. The variability of intervention protocols and limited number of dementia-specific trials highlight the need for standardized, high-quality randomized studies. Exergaming represents a feasible and engaging therapeutic option that may complement traditional rehabilitation in dementia care.