Exergaming and older adult cognition

Background: Dementia cases may reach 100 million by 2050. Interventions are sought to curb or prevent cognitive decline. Exercise yields cognitive benefits, but few older adults exercise. Virtual reality-enhanced exercise or “exergames” may elicit greater participation.

Purpose: To test the following hypotheses: (1) stationary cycling with virtual reality tours (“cybercycle”) will enhance executive function and clinical status more than traditional exercise; (2) exercise effort will explain improvement; and (3) brain-derived neurotrophic growth factor (BDNF) will increase.

Design: Multi-site cluster randomized clinical trial (RCT) of the impact of 3 months of cybercycling versus traditional exercise, on cognitive function in older adults. Data were collected in 2008-2010; analyses were conducted in 2010-2011.

Setting/participants: 102 older adults from eight retirement communities enrolled; 79 were randomized and 63 completed.

Interventions: A recumbent stationary ergometer was utilized; virtual reality tours and competitors were enabled on the cybercycle.

Results: Intent-to-treat analyses, controlling for age, education, and cluster randomization, revealed a significant group X time interaction for composite executive function. Cybercycling yielded a medium effect over traditional exercise. Cybercyclists had a 23% relative risk reduction in clinical progression to MCI. Exercise effort and fitness were comparable, suggesting another underlying mechanism. A significant groupXtime interaction for BDNF indicated enhanced neuroplasticity among cybercyclists.

Conclusions: Cybercycling older adults achieved better cognitive function than traditional exercisers, for the same effort, suggesting that simultaneous cognitive and physical exercise has greater potential for preventing cognitive decline.