Exergaming and Dementia: Can Exercise Video Games Slow Cognitive Decline?

Interactive gaming consoles like the Nintendo Wii and Xbox Kinect have become popular platforms, offering family-friendly exercise-related games — ‘exergames’ — such as dancing to choreographs of popular songs, following moves of actors on the screen. But the benefits of exergames may extend well beyond home entertainment: A recent study found that exergames could potentially boost brain health, not to mention physical health, in older adults with dementia. 

In the randomized, controlled pilot trial of 45 long-term care residents with dementia, those who participated in an exergame program had greater cognitive functioning and physical fitness within eight weeks. Symptoms of dementia such as apathy, agitation and disorientation can make it challenging for people to remain physically active. But researchers believe that exergaming may be an alternative to regular exercise — an activity shown to reduce cognitive decline and behavioral symptoms. 

“For the first time, there’s hope that through targeted play we will be able not only to delay but also weaken the symptoms of dementia,” Eling de Bruin, co-author of the study and researcher at the university ETH Zurich, said in a news release. 

In the study published in Alzheimer’s Research & Therapy, de Bruin and colleagues recruited residents with dementia from two Belgian care homes, randomly dividing them into an intervention group and a control group. 

Three times a week, people in both the control and intervention groups, who were on average 85 years old, participated in 15-minute sessions of two different activities: Participants in the control group sat and watched music videos of their choice. Those in the intervention group participated in an exergame program custom-tailored by a physical therapist to each person’s abilities. 

In the exergame, patterns on a screen indicated where users should step on a floor panel, which measured steps, balance and weight transfer. The quicker and more accurate their reactions were, the more difficult the game became. 

Following the eight-week program, residents in the intervention group showed an overall improvement in cognitive function including memory, attention and orientation, compared to controls. They also had reduced symptoms of depression and greater physical abilities of balance, mobility, walking speed and reaction time. 

According to the researchers, the preliminary results are promising, but the findings should be interpreted with caution. Larger clinical trials comparing exergames with an active intervention such as aerobic exercise are required, they noted. 

Nathalie Swinnen, co-author of the study and doctoral student at ETH Zurich, said she and her colleagues have launched a new study to investigate the efficacy of a program involving a recently developed training device. Participants with dementia engage in exergaming sessions three times a week over a 12-week period while controls do more traditional exercises including squatting and walking.

Past Research, Future Studies

According to Swinnen, innovative technologies have opened up new opportunities to engage long-term care residents with dementia through exergames — an approach that may motivate them to stay active in ways that are pleasurable as well. 

In a paper published last year, Swinnen and colleagues evaluated data from 671 participants in eight clinical trials, finding strong evidence for the benefits of exergaming for physical and emotional health, and preliminary results showing its effects on improving cognition, among people with dementia.

But, there is still work to be done to determine the extent of the benefits: “[O]f importance for clinical practice, it remains inconclusive whether the exergame intervention is superior [or] inferior compared to a regular exercise intervention,“ Swinnen wrote in an email to Being Patient.  

“Although the current evidence is promising and of high methodological quality,” she added, “more controlled trials are needed to confirm the existing evidence before exergames can be recommended in treatment guidelines.” 

Swinnen said follow-up studies should also determine whether the effects of exergames on cognition and physical abilities sustain over time and transfer to people’s abilities to carry out daily activities. 

Without a cure for dementia or treatment to stop its progression, researchers of the recent study wrote that one of the main goals of caring for residents of long-term care with the condition is to preserve or improve their quality of life. Exergames could potentially be one approach to enhance their well-being.