Feasibility of a 3‐Dimensional Exergame to Promote Integrated Cognitive and Physical Activity in Aging Adults

Abstract

AbstractBackgroundEvidence suggests that bi‐directional associations exist between cognition and mobility that magnify with increasing age. Both cognition and mobility are important to maintaining independent function in daily life. These and other findings suggest that cognition and mobility may share common neural substrates that can be trained simultaneously through real‐world simulations that safely promote navigation through complex virtual environments. However, few interventions explicitly train on cognition and mobility simultaneously. We optimized an immersive, 3‐Dimensional (3‐D) exergame to simultaneously train cognitive and motor functions in a community‐based setting for older adults.MethodWe recruited 16 older adults from an independent living community, with varying levels of physical function. Participants completed one‐hour sessions three times each week for five weeks for a total of 15 sessions. The customized game provides an immersive virtual oceanic environment in which the participants control a simulated dolphin (“Bandit”) that responds to the participant’s desired direction in 3‐D space and amid other oceanic fish, including sharks, orcas and small pods of fish. Participants used their dominant hand, tracked by motion sensors, to navigate this world to help “Bandit” eat fish, avoid being bitten by sharks, and jump out of the water. Players advanced in levels after mastering the preceding level. After completing all 110 game levels, participants switched to their non‐dominant hand to remaster all levels of the exergame again.Before and after the program, participants completed tests of memory, executive function, and speed of processing.ResultAll participants successfully completed the intervention, with the exception of one participant, with a vestibular disorder. In adjusted models (age, sex, education), post‐intervention improvement in processing speed was marginally significant (p = 0.06). No other cognitive improvements were found.ConclusionOur feasibility study demonstrated that we can effectively use this innovative exergame platform as a clinic‐ or community‐ based tool for individuals to safely practice and promote integrated skills related to complex, real‐world navigation.