In Costa Rica, the elderly population has increased dramatically over the last decade. Little is known about the acute effects and chronic adaptations to video game (i.e., Exergames) training in this population. PURPOSE: To examine the acute effects and chronic adaptations to an exergame training program on attention, concentration, static and dynamic balance in older adults. METHODS: Twenty-seven healthy older adults (Mean age = 63.15 ± 5.79 yr.), were randomly assigned to an experimental and a control group. The experimental group played the Dance Dance Revolution (DDR) video game. A battery of physical and cognitive tests was applied before and after 15 sessions (3 sessions/week, 5 weeks) to measure attention, concentration, static and dynamic balance. RESULTS: Compared to controls, significant mean differences were found in the acute effect on dynamic balance (Pre = 5.19 ± 0.29 vs. Post= 4.78 ± 0.15 s, p = 0.0001), concentration (Pre = 740.71 ± 20.43 vs. Post = 766.14 ± 8.52 pts., p = 0.015), and attention (Pre = 54.93 ± 6.92 vs. Post = 69.14 ± 3.48 pts., p = 0.0001). Significant chronic effects were also found on concentration (Pre = 740.71 ± 20.43 vs. Post = 770.5 ± 7.22 pts., p = 0.002), attention (Pre = 54.93 ± 6.92 vs. Post = 72.86 ± 1.66 pts., p = 0.0001), and static (Pre = 0.0154 ± 0.0015 vs. Post = 0.0124 ± 0.0020 m/s, p = 0.006) and dynamic balance (Pre = 5.19 ± 0.29 vs. Post = 3.93 ± 0.27 s, p = 0.0001). CONCLUSIONS: Acute and chronic improvements were observed in attention, concentration, dynamic balance and static balance in healthy older adults playing the DDR exergame.