Exergaming is a new and popular exercise regimen that can combine physical exercise and cognitive training, and has the potential to improve cognitive function and dual-task mobility among older adults. PURPOSE: To test whether an 8-week exergaming program that utilizes custom Microsoft Kinect-based motion-tracking exergames would improve cognitive function and dual-task mobility compared to a traditional physical exercise program among older adults at risk for falling. METHODS: A quasi-experimental intervention study was conducted with adults aged ≥ 65 years living in senior living communities and reporting mobility difficulties or a fall in the past year were enrolled to an exergaming program or a traditional physical exercise program, offered twice weekly for 8 weeks. Cognitive function and dual-task mobility were measured before and after the 8-week intervention. A Wilcoxon rank-sum test was used to compare the group difference and further adjust for exercise intensity (ratings of perceived exertion, RPE) using a rank transform method. RESULTS: Twenty-nine participants (age 77±7 yrs) completed either the exergaming program (n=15) or the traditional physical exercise program (n=14). Statistically significant group differences in Trail Making Test Part A (TMT-A, p<0.05) and single-task gait speed, stride length, and stride width (all p<0.05) and marginal group differences in Mini-Mental State Examination (MMSE, p=0.06) were observed, all favoring the exergaming program. After adjusting for RPE, effects remained statistically significant for most single-task gait measurements (all p≤0.05), and marginal group differences in TMT-A (p=0.06) and MMSE (p=0.07) were observed. There were no statistically significant group differences in dual-task gait performance. CONCLUSIONS: Exergaming marginally improved global cognitive status and had a protective effect against declines in executive function and single-task gait measurements compared to traditional physical exercise. The findings support the need for larger studies to determine cognitive and mobility benefits related to exergaming. (Supported by a Doctoral Dissertation Research Grant from the University of Massachusetts Boston)