The effects of exergaming interventions on cognition and physical activity of institutionalized older adults: A systematic review

Objective: Physical activity has a powerful protective effect on older adults’ cognition and emotional well-being. For older adults living in long-term care, however, there are limited opportunities for engaging in physical activities, and therefore they are at high-risk of experiencing the consequences of continuous physical inactivity. Older adults with mild cognitive impairments (CI) or dementia experience more inactivity, are more socially withdrawn, and are at a significantly higher risk of decline. Exergames have been posed as a promising way to improve motivation to exercise for institutionalized older adults with dementia, with associated benefits to their cognition, well-being, social engagement, and physical capabilities, however the effects of exergaming on this vulnerable and complex population is unclear. This review aims to explore the current evidence and research gaps in these effects of exergaming interventions for this population. Method Four databases (MEDLINE, CINAHL, PsycINFO, and Compendex), were systematically searched. Quantitative studies examining cognitive, emotional, motivational, social and physical effects of exergaming interventions for older adults with dementia or CI living in long-term care were eligible for inclusion. The search included exergaming interventions and all institutionalized older adults. Thorough screening identified studies that had institutionalized older adults with mild CI or dementia. Result: The search yielded 206 citations; of those, 3 met inclusion criteria. The study designs, outcome measures and interventions varied greatly. Two studies looked at physical effects of exergaming suggested balance and motor function could be improved. Two of the three studies reported a significant pre/post-test improvement to motor function but gait did not improve in both thesestudies. When looking at cognitive benefits of exergames, studies provided indication that participants improved their alertness, concentration and memory capabilities. In one of the three studies though, there were no increase in memory capabilities. The studies were of very low to low quality. Furthermore, the studies showed that playing these games did not result in any adverse events, or exacerbate responsive behaviours while the participants were playing. There was no subgroup analysis done in any of the three studies. Conclusion: There is insufficient evidence that currently available exergames benefit cognition and motor capabilities of institutionalized older adults with mild cognitive impairment or dementia. More robust research looking at the effects of exergames on cognition and motor function is needed. Additional development of exergames tailored to the needs and interests of this population is also required