Exergames (EG) changed brain structure and neuroplasticity in older adults.

Cerebral bases of motor tasks changed in healthy participants after EG.

Changes in key regions (e.g., DMN) found in neurocognitive disorder patients.

Some structural and functional brain findings need stronger study validation.

Exergames (EG) are interactive video games that require physical activity and use gamification to make exercise more engaging. EG interventions demonstrated various benefits for older adults including improved mental health, quality of life, and a reduced risk of falls. Enhanced cognition is considered one of the principal targets driving these benefits. This systematic review aimed to identify the neurobiological effects of EG interventions in healthy older adults and those with neurocognitive disorders. We systematically searched major databases for studies from inception up until June 2024 and included 12 reports. Findings revealed that EG interventions induced structural and functional brain changes, accompanied by improved cognitive and motor performance, as well as neuroplastic adaptations, such as elevated BDNF levels and enhanced neurovascular coupling, in healthy older adults. Similar findings were reported in older adults with neurocognitive disorders, though only in two studies, one showing increased frontal and temporal activity at rest, and the other reporting an increase in brain volume. Notably, methodological limitations in some studies, particularly those involving neuroimaging, underline the preliminary nature of the findings. Furthermore, the small number of studies included, especially those focusing on older adults with neurocognitive disorders, who often present with diverse clinical profiles, emphasizes the need for further research to validate these encouraging but currently low-evidence findings.

Exergame

Older adults

Neurocognitive disorders

Brain

Aging brain

EEG

MRI

Neuroplasticity

BDNF

© 2025 The Authors. Published by Elsevier Inc.