Role of Exergaming in Memory and Attention Outcomes in Older Adults: A Pre–post Exploratory Study

Abstract

Background: Age-related cognitive decline commonly affects memory, attention, and executive functioning, leading to reduced independence and quality of life in older adults. Exergaming, which integrates physical exercise with interactive digital gaming, has been proposed as a motor–cognitive approach that may support cognitive health. Objective: To examine changes in attention, working memory, and overall cognitive function following a structured six-week exergaming program in community-dwelling older adults. Methods: This single-group pre–post exploratory study included 30 adults aged 65 years and above recruited from a university-affiliated physiotherapy center. Participants completed 18 supervised exergaming sessions (30–35 minutes each) over six weeks using a motion-sensing gaming system (Xbox 360 Kinect). Cognitive performance was assessed before and after the intervention using the Trail Making Test (Parts A and B), Digit Span Test (forward and backward), and the Montreal Cognitive Assessment (MoCA). Paired t-tests were used to analyze within-group changes, and effect sizes were calculated to estimate the magnitude of observed differences, with statistical significance set at p ≤ 0.05. Results: Statistically significant pre–post improvements were observed across all cognitive measures. Completion times for TMT-A and TMT-B decreased significantly, while Digit Span Forward and Backward scores and MoCA total scores increased following the intervention (p < 0.001 for all outcomes). Effect size estimates suggested moderate to large changes across attention, working memory, and global cognition. Conclusion: Participation in a six-week exergaming program was associated with improvements in attention, working memory, and overall cognitive performance among community-dwelling older adults. However, as the study employed a single-group pre–post design without a control group, causal inferences cannot be drawn. The observed improvements may partly reflect practice effects, participant expectancy, or other concurrent influences. Therefore, these findings should be considered preliminary and exploratory, highlighting the need for randomized controlled trials with appropriate comparator groups to establish effectiveness.