To evaluate the feasibility of longer-term use and potential cognitive benefit of neuro-exergaming for Parkinson’s Disease. It is estimated that up to 40% of PD patients would meet criteria for a diagnosis of mild cognitive impairment and that up to 80% will develop dementia over the course of the disease (Kenney et al, 2022). There has been a call for lifestyle interventions for older adults to prevent, delay or ameliorate cognitive decline via non-pharmacological interventions such as exercise (Cammisuli et al, 2019).

Virtual reality games that combine physical activity and brain-training may help slow cognitive decline in older adults, research suggests.

Prior pilot studies with MCI found promising cognitive benefits from iPACES for both patient and caregivers using it in-home for three months (Anderson-Hanley et al., 2018). This pilot study examined the feasibility of iPACES for in-home use by older Hispanic/Latinx adults. Information was gathered regarding usability of the equipment and game, that will aid in further development of neuro-exergames for Spanish-speaking older adults.

Obesity continues to plague our society as a major public health issue. The latest obesity prevalence statistics show over 70% of U.S. adults are overweight and 40% of U.S. adults and 20% of youth are obese. Unfortunately, the prevalence of obesity among non-Hispanic blacks and Hispanic adults is even higher at 47%.1 Healthcare costs associated with obesity-related disease are in excess of $190 billion per year.2,3 In addition, the economic impact expands past healthcare costs and includes indirect costs associated with wages lost due to employee absenteeism, decreased work productivity, poor academic performance, impaired cognition, and low morale both in the present and future. These staggering numbers clearly highlight the necessity for immediate intervention among all groups and ages of our population. While progress has occurred in illuminating certain pathways controlling energy homeostasis,4,5 scientific advances have thus far failed to prevent the worldwide spread of obesity. The current definition of overweight for an adult is a BMI between 25–29.9 kg/m2 and for obese ≥30 kg/m2.

Background: Alzheimer’s and related dementias are on the rise, and older adults and their families are seeking accessible and effective ways to stave off or ameliorate mild cognitive impairment (MCI). Aim: This pilot clinical trial (ClinicalTrials.gov Identifier: 03069391) examined neuropsychological and neurobiological outcomes of interactive physical and mental exercise. Participants and methods: Older adults (MCI and caregivers) were enrolled in a 3-month, in-home trial of a portable neuro-exergame (the interactive Physical and Cognitive Exercise System [iPACESTM]), in which they pedaled and steered along a virtual bike path to complete a list of errands (Memory LaneTM). Neuropsychological function and salivary biomarkers were measured at pre-, mid-, and posttrial. Ten older adults complied with the recommended use of iPACES (complete dose; $2×/wk, 67% of the 15 who also had pre- and postevaluation data). Statistical analyses compared change over time and also change among those with a complete dose vs inadequate dose. Correlations between change in neuropsychological and biomarker measures were also examined. Results: Executive function and verbal memory increased after 3 months (p = 0.01; no significant change was found with an inadequate dose). Change in salivary biomarkers was moderately associated with increasing cognition (cortisol, r = 0.68; IGF-1, r = 0.37). Conclusion: Further research is needed, but these pilot data provide preliminary indications to suggest neuro-exergaming can impact cognitive function, perhaps via neurobiological mechanisms, and as such may provide an effective and practical way to promote healthy aging.

Abstract: Given increasing longevity worldwide, older adults and caregivers are seeking ways to curb cognitive decline especially for those with mild cognitive impairment (MCI, now mild neurocognitive disorder, mNCD, Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-V). This quasi-experimental, within-subjects pilot clinical trial was designed to replicate and extend the study of cognitive benefits for MCI by improving upon our prior interactive Physical and Cognitive Exercise Study (iPACES v1.0) by increasing the usability of the neuro-exergame and exploring possible underlying neurobiological mechanisms. Older adults were enrolled in a three-month, in-home trial of a portable neuro-exergame (iPACES™ v2.0) where participants pedaled and steered along a virtual bike path (Memory Lane™). Neuropsychological function was assessed at baseline after component familiarization intervals (e.g., two weeks of exercise-only, game-only, etc.) and after three months of interactive neuro-exergame intervention. Fourteen participants were enrolled in the study and seven completed the final evaluation. Intent-to-treat analyses were conducted with imputed missing data (total n = 14). Significant improvement in executive function (Stroop) was found (d = 0.68, p = 0.02) only. Changes in salivary biomarkers (cortisol and insulin-like growth factor 1; IGF-1) were significantly associated with improved cognition. Further research is needed, but pilot data suggest that a portable in-home neuro-exergame may be an additional, practical tool to fight back against cognitive decline and dementia.

Dementia cases are on the rise and researchers seek innovative ways to prevent or ameliorate cognitive impairment in later life. Some research

has reported that combining mental and physical exercise may benefit cognition more than either alone. This randomized pilot trial examined

the feasibility and cognitive benefit for older adults (n = 30) of a single bout of neuro-exergaming (physical activity with cognitive training)

using an interactive physical and cognitive exercise system (iPACES), compared with that of exergaming or neurogaming alone. Intent-to-treat

and sensitivity analyses were conducted using repeated-measures ANOVA, controlling for age, sex, and education. A significant interaction

effect was found for executive function (Color Trails 2), with a significant improvement in the neuro-exergaming condition. Results dem-

onstrate feasibility for older adults to use a novel and theoretically-derived neuro-exergame, and also provide promising new evidence that

neuro-exergaming can yield greater cognitive benefit than either of its component parts.